Impacts of the Finnish service screening programme on breast cancer rates

Anttila, Ahti; Sarkeala, Tytti; Hakulinen, Timo; Heinävaara, Sirpa

doi:10.1186/1471-2458-8-38

Cited by 35 publications

(57 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most of the study population in Anttila et al 19 was included in Sarkeala et al 9 An overlap similar of that seen in Finland was found for the six Swedish publications, with the 13-area study 18 giving the best coverage of the Swedish data.…”

Section: Methodsmentioning

confidence: 69%

“…One study had an accrual period shorter than the follow-up period and used breast cancer cases from one age group and breast cancer deaths from an age group including older women. 19 This study reported a RR of 0.89. The studies with the most unbiased comparisons are those able to control for changes over time without introducing a healthy user bias and where the accrual period is similar to the follow-up time for breast cancer deaths (those in the top half of Tables 1 and 2).…”

Section: Resultsmentioning

confidence: 85%

“…Three studies were from Sweden, 15,16,18 three from Finland 8,9,19 and one from Spain 17 ( Table 3). In this group, all RRs were statistically significant ranging from 0.52 to 0.82.…”

Section: Resultsmentioning

confidence: 99%

“…However, the data covered the period 1987 -1992, and concern has been raised about the relevance of older data for evaluating the potential impact of mammography screening in more recent times. Anttila et al 19 was the largest study but it had an accrual period shorter than the follow-up and used different age groups for breast cancer diagnoses and breast cancer deaths. The Sarkeala et al studies 8,9 were the most recent and only had minor overlap with the Hakama et al Sarkeala et al 9 only used a historical comparison group, making it difficult to distinguish between a mortality reduction due to screening and other temporal changes, such as improvements in treatment.…”

Section: ããããmentioning

confidence: 99%

See 3 more Smart Citations

Breast Cancer Mortality in Mammographic Screening in Europe: A Review of Incidence-Based Mortality Studies

et al. 2012

View full text Add to dashboard Cite

Objectives To estimate the impact of service mammography screening on breast cancer mortality using European incidence-based mortality (IBM) studies (or refined mortality studies). IBM studies include only breast cancer deaths occurring in women with breast cancer diagnosed after their first invitation to screening. Methods We conducted a literature review and identified 20 publications based on IBM studies. They were classified according to the method used for estimating the expected breast cancer mortality in the absence of screening: (1) women not yet invited; (2) historical data from the same region as well as from historical and current data from a region without screening; and (3) historical comparison group combined with data for non-participants. Results The estimated effect of mammography screening on breast cancer mortality varied across studies. The relative risks were 0.76 -0.81 in group 1; 0.75 -0.90 in group 2; and 0.52 -0.89 in group 3. Study databases overlapped in both Swedish and Finnish studies, adjustment for lead time was not optimal in all studies, and some studies had other methodological limitations. There was less variability in the relative risks after allowing for the methodological shortcomings. Conclusions Based on evidence from the most methodologically sound IBM studies, the most likely impact of European service mammography screening programmes was a breast cancer mortality reduction of 26% (95% confidence interval 13 -36%) among women invited for screening and followed up for 6-11 years.

show abstract

Section: Methodsmentioning

confidence: 69%

Section: Resultsmentioning

confidence: 85%

“…Three studies were from Sweden, 15,16,18 three from Finland 8,9,19 and one from Spain 17 ( Table 3). In this group, all RRs were statistically significant ranging from 0.52 to 0.82.…”

Section: Resultsmentioning

confidence: 99%

Section: ããããmentioning

confidence: 99%

See 2 more Smart Citations

Breast Cancer Mortality in Mammographic Screening in Europe: A Review of Incidence-Based Mortality Studies

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Mortality in this age group started to decline significantly already since 2000 -about four years before the start of organized screening. Considering that it takes about five years for incidence and mortality to become stable after screening [21], it is difficult to attribute the observed decrease in mortality to the impact of organized screening, although opportunistic screening can obscure the effect of organized screening [22]. It was shown previously that the proportion of localized cancers in age group 50-59 increased from 33% in 1995-1999 to 46% in 2000-2004.…”

Section: Discussionmentioning

confidence: 99%

Recent changes in breast cancer incidence and mortality in Estonia: Transition to the west

et al. 2016

View full text Add to dashboard Cite

Background The aim of this study was to examine breast cancer (BC) incidence and mortality trends in Estonia during recent decades and to compare the pattern of these trends with other selected European countries and regions. We attempt to explain the findings in relation to changes in Estonian society and healthcare system. Methods BC incidence (1985-2012) and mortality (1985-2013) data for Estonia were obtained from the Estonian Cancer Registry and Statistics Estonia. Data for selected European countries were obtained from the EUREG database. Joinpoint regression was used to analyze age-standardized rates in Estonia by age. For international comparison of incidence and mortality rates, we used scatterplot with 95% confidence ellipses and the mortality to incidence ratio. Results The overall BC incidence continues to increase in Estonia, while mortality has been in decline since 2000. Both incidence and mortality trends varied considerably across age groups. Among women aged 60 years and older, BC incidence increased at a rate of nearly 3% per year. Significant decrease in mortality was seen only among women aged 50-59 years. Comparison of scatterplots between countries and regions revealed two clusters in Europe separated along the incidence axis. The correlation between incidence and mortality in Estonia changed its direction in the mid-1990s. Conclusion In recent years, the dynamics of BC burden in Estonia has transitioned towards the high incidence-low mortality type model, which is characteristic to Western, Northern and Southern Europe. Although overall BC incidence is much lower in Estonia than in more affluent European countries, mortality from BC is still relatively high, particularly among elderly women.

show abstract

Decreasing incidence of late‐stage breast cancer after the introduction of organized mammography screening in Italy

Foca

Mancini

Bucchi

et al. 2013

Cancer

View full text Add to dashboard Cite

the IMPACT Working Group BACKGROUND: After the introduction of a mammography screening program, the incidence of late-stage breast cancer is expected to decrease. The objective of the current study was to evaluate variations in the total incidence of breast cancer and in the incidence of breast cancers with a pathologic tumor (pT) classification of pT2 through pT4 after the introduction of mammography screening in 6 Italian administrative regions. METHODS: The study area included 700 municipalities, with a total population of 692,824 women ages 55 to 74 years, that were targeted by organized mammography screening between 1991 and 2005. The year screening started at the municipal level (year 1) was identified. The years of screening were numbered from 1 to 8. The ratio of the observed 2-year, agestandardized (Europe) incidence rate to the expected rate (the incidence rate ratio [IRR]) was calculated. Expected rates were estimated assuming that the incidence of breast cancer was stable and was equivalent to that in the last 3 years before year 1. RESULTS: The study was based on a total of 14,447 incident breast cancers, including 4036 pT2 through pT4 breast cancers. The total IRR was 1.35 (95% confidence interval, 1.03-1.41) in years 1 and 2, 1.16 (95% confidence interval, 1.10-1.21) in years 3 and 4, 1.14 (95% confidence interval, 1.08-1.20) in years 5 and 6, and 1.14 (95% confidence interval, 1.08-1.21) in years 7 and 8. The IRR for pT2 through pT4 breast cancers was 0.97 (95% confidence interval, 0.90-1.04) in years 1 and 2, 0.81 (95% confidence interval, 0.75-0.88) in years 3 and 4, 0.79 (95% confidence interval, 0.73-0.87) in years 5 and 6, and 0.71 (95% confidence interval, 0.64-0.79) in years 7 and 8. CONCLU-SIONS: A significant and stable decrease in the incidence of late-stage breast cancer was observed from the third year of screening onward, when the IRR varied between 0.81 and 0.71. Cancer 2013;119:2022-8.

show abstract

Impacts of the Finnish service screening programme on breast cancer rates

Abstract: Background: The aim of the current study was to examine impacts of the Finnish breast cancer (BC) screening programme on the population-based incidence and mortality rates. The programme has been historically targeted to a rather narrow age band, mainly women of ages 50-59 years.

Cited by 35 publications

References 26 publications

Breast Cancer Mortality in Mammographic Screening in Europe: A Review of Incidence-Based Mortality Studies

Breast Cancer Mortality in Mammographic Screening in Europe: A Review of Incidence-Based Mortality Studies

Recent changes in breast cancer incidence and mortality in Estonia: Transition to the west

Decreasing incidence of late‐stage breast cancer after the introduction of organized mammography screening in Italy

Contact Info

Product

Resources

About