Irregular screening participation increases advanced stage breast cancer at diagnosis: A population-based study

Ding, Lilu; Greuter, Marcel J W; Truyen, Inge; Goossens, Mathijs; Schutter, Harlinde De; Bock, Geertruida H. de; Hal, Guido Van

doi:10.1016/j.breast.2022.07.004

Cited by 6 publications

(6 citation statements)

References 32 publications

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“…This might result in larger and more advanced tumors, which in turn require more extensive treatment at a higher cost compared to early detected cancer (23). Our findings are in line with the Dutch study, where irregular attendance was associated with increased risk of advanced breast cancer (9), and might also support the study by Duffy et al, showing lower breast cancer mortality among regular versus irregular attendees (8).…”

Section: Discussionsupporting

confidence: 91%

“…6,7 Irregular screening attendance has been shown to be associated with higher breast cancer mortality compared to regular attendance. 8 A study from the Netherlands reported a 17% increased risk of advanced breast cancer after irregular versus regular screening attendance, 9 but further knowledge is needed to better understand the effect of the regularity of attendance on early performance measures. 10,11 Irregular screening attendance is expected to increase the time between disease onset and detection compared to regular attendance, which in turn might lead to delayed diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…Irregular screening attendance has been shown to be associated with higher breast cancer mortality compared to regular attendance (8). A study from the Netherlands reported 17% increased risk of advanced breast cancer after irregular versus regular screening attendance (9), but further knowledge is needed to better understand the effect of the regularity of attendance on early performance measures (10,11).…”

Section: Introductionmentioning

confidence: 99%

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Early performance measures following regular versus irregular screening attendance in the population-based screening program for breast cancer in Norway

Thy,

Larsen,

Vigeland

et al. 2023

J Med Screen

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Objective Irregular attendance in breast cancer screening has been associated with higher breast cancer mortality compared to regular attendance. Early performance measures of a screening program following regular versus irregular screening attendance have been less studied. We aimed to investigate early performance measures following regular versus irregular screening attendance. Methods We used information from 3,302,396 screening examinations from the Cancer Registry of Norway. Examinations were classified as regular or irregular. Regular was defined as an examination 2 years ± 6 months after the prior examination, and irregular examination >2 years and 6 months after prior examination. Performance measures included recall, biopsy, screen-detected and interval cancer, positive predictive values, and histopathological tumor characteristics. Results Recall rate was 2.4% (72,429/3,070,068) for regular and 3.5% (8217/232,328) for irregular examinations. The biopsy rate was 1.0% (29,197/3,070,068) for regular and 1.7% (3825/232,328) for irregular examinations, while the rate of screen-detected cancers 0.51% (15,664/3,070,068) versus 0.86% (2003/232,328), respectively. The adjusted odds ratio was 1.53 (95% CI: 1.49–1.56) for recall, 1.73 (95% CI: 1.68–1.80) for biopsy, and 1.68 (95% CI: 1.60–1.76) for screen-detected cancer after irregular examinations compared to regular examinations. The proportion of lymph node-positive tumors was 20.1% (2553/12,719) for regular and 25.6% (426/1662) for irregular examinations. Conclusion Irregular attendance was linked to higher rates of recall, needle biopsies, and cancer detection. Cancers detected after irregular examinations had less favorable histopathological tumor characteristics compared to cancers detected after regular examinations. Women should be encouraged to attend screening when invited to avoid delays in diagnosis.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early performance measures following regular versus irregular screening attendance in the population-based screening program for breast cancer in Norway

Thy,

Larsen,

Vigeland

et al. 2023

J Med Screen

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“…On the other hand, the higher advanced BC (stages III-IV) incidence rates observed in deprived areas could be explained by the increased difficulty in accessing healthcare and lower awareness of the disease, leading to lower screening uptake. For instance, two studies carried out in the Netherlands and in the Flanders region have shown that stages III-IV BC incidence in non-screened women (eligible for the organized national screening program) was more than double than in their screened counterparts [8,23]. Different factors, such as limited knowledge about mammography screening programs, misconception regarding cancer and mammography, and awareness of cancer warning signs have been identified as having negatively influenced screening uptake in deprived areas [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic Deprivation and Invasive Breast Cancer Incidence by Stage at Diagnosis: A Possible Explanation to the Breast Cancer Social Paradox

Borghi,

Delacôte,

Delacour-Billon

et al. 2024

Cancers

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In this study, we assessed the influence of area-based socioeconomic deprivation on the incidence of invasive breast cancer (BC) in France, according to stage at diagnosis. All women from six mainland French departments, aged 15+ years, and diagnosed with a primary invasive breast carcinoma between 2008 and 2015 were included (n = 33,298). Area-based socioeconomic deprivation was determined using the French version of the European Deprivation Index. Age-standardized incidence rates (ASIR) by socioeconomic deprivation and stage at diagnosis were compared estimating incidence rate ratios (IRRs) adjusted for age at diagnosis and rurality of residence. Compared to the most affluent areas, significantly lower IRRs were found in the most deprived areas for all-stages (0.85, 95% CI 0.81–0.89), stage I (0.77, 95% CI 0.72–0.82), and stage II (0.84, 95% CI 0.78–0.90). On the contrary, for stages III–IV, significantly higher IRRs (1.18, 95% CI 1.08–1.29) were found in the most deprived areas. These findings provide a possible explanation to similar or higher mortality rates, despite overall lower incidence rates, observed in women living in more deprived areas when compared to their affluent counterparts. Socioeconomic inequalities in access to healthcare services, including screening, could be plausible explanations for this phenomenon, underlying the need for further research.

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“…Several observational studies in developed countries suggest an average reduction in BC mortality by 23% among women invited to participate and by 40% among women actually attending the screening [ 27 , 29 ]. A Dutch study reports an almost six-fold higher risk of late-stage presentation for women never attending a screening programme compared to women attending a screening programme [ 7 ▪ ]. A population-based study, matching GLOBOCAN 2020 age-standardised mortality rates for BC to a broad panel of standardised national health system indicators for 148 countries, found that countries attaining a sustained decrease in mortality rates had at least 60% of newly diagnosed BC patients presenting with stage I or II disease, highlighting the impact of early diagnosis on mortality rates [ 33 ].…”

Section: Early Detectionmentioning

confidence: 99%

Epidemiology trends and progress in breast cancer survival: earlier diagnosis, new therapeutics

Amato,

Guarneri,

Girardi

2023

Current Opinion in Oncology

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Purpose of review In this review we will critically appraise the latest evidence on breast cancer (BC) survival trends and discuss how these may reflect breakthroughs in early diagnosis and treatment approaches. We will address the wide global inequalities in BC survival and review the ongoing initiatives aimed at improving cancer control worldwide. Recent findings BC outcomes have improved in high-income countries during the last decades, following the implementation of strategies for early detection and optimal multimodality treatment. Novel therapeutics, such as anti-HER2 targeted treatments, have also contributed to the progress in BC survival. However, BC mortality is still high in low-income countries, due to the lack of optimal healthcare infrastructures. In the context of marked inequities in BC management across world regions, international collaborations such as the Global Breast Cancer Initiative and the Global Initiative for Cancer Registry Development work to foster capacity-building in developing countries, tackle the burden of BC and deliver the Sustainable Development Goals by 2030. Summary Collection of robust, high-quality data from population-based cancer registries is crucial to drive and refine public health interventions. Population-based data are also the litmus paper to evaluate the real-world impact of clinical advances and monitor progress.

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Irregular screening participation increases advanced stage breast cancer at diagnosis: A population-based study

Cited by 6 publications

References 32 publications

Early performance measures following regular versus irregular screening attendance in the population-based screening program for breast cancer in Norway

Early performance measures following regular versus irregular screening attendance in the population-based screening program for breast cancer in Norway

Socioeconomic Deprivation and Invasive Breast Cancer Incidence by Stage at Diagnosis: A Possible Explanation to the Breast Cancer Social Paradox

Epidemiology trends and progress in breast cancer survival: earlier diagnosis, new therapeutics

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