Impact of Screening on Breast Cancer Mortality: The UK Program 20 Years On

Massat, Nathalie J.; Dibden, Amanda; Parmar, Dharmishta; Cuzick, Jack; Sasieni, Peter; Duffy, Stephen W.

doi:10.1158/1055-9965.epi-15-0803

Cited by 98 publications

(87 citation statements)

References 31 publications

(35 reference statements)

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“…More than 220,000 people are diagnosed with cancer each year in England, and it causes more than 128,000 deaths [30]. Seventy percent of these deaths occur in people above the age of seventy five [30].…”

Section: Cancermentioning

confidence: 99%

“…Seventy percent of these deaths occur in people above the age of seventy five [30]. Fundamental to prevention efforts is cancer screening; which in England is offered for breast, bowel and cervical cancer as part of a national screening framework.…”

Section: Cancermentioning

confidence: 99%

“…The Statins controversy may have led to medication non-compliance in as many as 200,000 UK patients with a possible extra 2,000 extra heart attacks or strokes in next decade [35]. High blood pressure was the primary or contributory cause of mortality for more than 410,000 in 2014 [30]; fortunately, there is also overwhelming evidence for the effectiveness of antihypertensive treatment in reducing strokes and cardiac events [36].…”

Section: Secondary Prevention Of Cva/ihdmentioning

confidence: 99%

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To What Extent can Chronic Diseases be Prevented in the United Kingdom and the Rest of the West?

Balogun¹

2017

J Community Med Health Educ

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The public health challenge of our generation and indeed generations to come is the effective management of the prevalence of non-communicable diseases. The task is fraught with complexity and plagued by paradox. On one hand we laud our efforts in increasing life expectancy but on the other we are stunned by dementia, the flipside of improved longevity. Depression has risen to prime place at the summit of morbidity tables in the West and obesity (in particular, child obesity) is on the rise. There is effective public health action aimed at smoking, physical activity uptake and obesity but the yield is slow and the process complex. Thrown into the mix is the powerful lobby of commercial interests opposed to real change and government inaction in tackling health inequalities. Noncommunicable disease account for 60% of annual deaths and will cost the global economy US$47 trillion over the next twenty years. With a concise review of mass public health action on targeted lifestyle choices, the author evaluates the future impact of NCDs in this most relevant of debates on the advance of chronic illness. 'NonCommunicable Diseases (NCDs) En Marche' seems a fitting contemporary title for this discourse; it symbolizes our current predicament with chronic or non-communicable diseases. NCDs are an enormous public health challenge and in many ways present a more formidable opponent than the old communicable disease foe. In the West, the leading cause of death and disease is ill health characterized by a protracted clinical course, linked to key life style choices or consumption behaviors and a rather complicated prevention strategy. NCDs now constitute 60% of global mortality, accounting for about 34 million deaths each year [1]. The focus of attention is how much prevention strategies can limit the scourge of NCDs in the western world? And how many of the unique hurdles can we scale on the way to reversing the ascend of NCD related ill-health?

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Section: Cancermentioning

confidence: 99%

Section: Cancermentioning

confidence: 99%

Section: Secondary Prevention Of Cva/ihdmentioning

confidence: 99%

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To What Extent can Chronic Diseases be Prevented in the United Kingdom and the Rest of the West?

Balogun¹

2017

J Community Med Health Educ

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“…Berrino raises the possibility of a healthy screenee bias in our estimates of the effect of being screened between 3 and 36 months before diagnosis and of ever being screened (1,2). The argument for the presence of such bias hangs on the exclusion of the 3-month period before diagnosis and therefore of the screendetected cancers.…”

mentioning

confidence: 97%

Impact of Screening on Breast Cancer Mortality—Response

Massat

Dibden

Parmar

et al. 2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Dr. Berrino raises the possibility of a healthy screenee bias in our estimates of the effect of being screened between 3 and 36 months before diagnosis and of ever being screened (1, 2). The argument for the presence of such bias hangs on the exclusion of the 3-month period before diagnosis and therefore of the screendetected cancers. We have repeated the analysis combining the interval within 3 months of diagnosis with 3 to 36 months (and including the diagnostic screen in women with screen-detected cancer). The estimated OR is 0.625 (95% CI, 0.50-0.78) corresponding to a 37.5% reduction in breast cancer mortality. However, this would underestimate the benefit of screening, as now, cases have two ways of being exposed to screening: if they were screen-detected or if they attended screening in the three years prior to diagnosis (3). Controls without breast cancer would have only one route to screening exposure, if they had attended in the three years prior to pseudodiagnosis. We countered this by extending the interval for controls matched to screen-detected cases beyond the date of diagnosis of the case to take account of the period during which the case's cancer would have been screen detectable but asymptomatic. Adding one year (i.e., 36 months prior to 12 months post) resulted in a reduction of 39.0% (OR, 0.61; 95% CI, 0.49-0.76) and adding 3 years 43.8% (OR, 0.56; 95% CI, 0.45-0.70).We accept that the 61% reduction in mortality cited in our abstract is likely to be an overestimate of what is achievable and that an estimate of around 40% is far more realistic. We disagree, however, with the proposed remedy of excluding all screens within a plausible preclinical screen-detectable period, which would remove much of the effect of screening. The life of a participant can only be saved by one screen, that which detects the cancer (4).

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“…Medical imaging has always been an integral part in breast cancer care ranging from diagnosis and staging to therapy monitoring and post-therapeutic follow-up [1][2][3][4][5]. Screening mammography has significantly contributed to the detection of breast cancer especially at an early, prognostically favorable stage and mammography has been demonstrated to reduce breast cancer mortality [6][7][8][9]. Mammography is relatively inexpensive and widely available.…”

mentioning

confidence: 99%

Advanced Imaging for Precision Medicine in Breast Cancer: From Morphology to Function

Pinker

2017

Breast Care

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Impact of Screening on Breast Cancer Mortality: The UK Program 20 Years On

Cited by 98 publications

References 31 publications

To What Extent can Chronic Diseases be Prevented in the United Kingdom and the Rest of the West?

To What Extent can Chronic Diseases be Prevented in the United Kingdom and the Rest of the West?

Impact of Screening on Breast Cancer Mortality—Response

Advanced Imaging for Precision Medicine in Breast Cancer: From Morphology to Function

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