Trends in breast cancer mortality in Sweden before and after implementation of mammography screening.

<h4>Background</h4>Incidence-based mortality modelling comparing the risk of breast cancer death in screened and unscreened women in nine Swedish counties has suggested a 39% risk reduction in women 40 to 69 years old after introduction of mammography screening in the 1980s and 1990s.<...

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Autores principales:	Jari Haukka, Graham Byrnes, Mathieu Boniol, Philippe Autier
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1705a1876fae4295b33763883637fc56
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spelling	oai:doaj.org-article:1705a1876fae4295b33763883637fc562021-11-04T06:07:51ZTrends in breast cancer mortality in Sweden before and after implementation of mammography screening.1932-620310.1371/journal.pone.0022422https://doaj.org/article/1705a1876fae4295b33763883637fc562011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21966354/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Incidence-based mortality modelling comparing the risk of breast cancer death in screened and unscreened women in nine Swedish counties has suggested a 39% risk reduction in women 40 to 69 years old after introduction of mammography screening in the 1980s and 1990s.<h4>Objective</h4>We evaluated changes in breast cancer mortality in the same nine Swedish counties using a model approach based on official Swedish breast cancer mortality statistics, robust to effects of over-diagnosis and treatment changes. Using mortality data from the NordCan database from 1974 until 2003, we estimated the change in breast cancer mortality before and after introduction of mammography screening in at least the 13 years that followed screening start.<h4>Results</h4>Breast mortality decreased by 16% (95% CI: 9 to 22%) in women 40 to 69, and by 11% (95% CI: 2 to 20%) in women 40 to 79 years of age.<h4>Discussion</h4>Without individual data it is impossible to completely separate the effects of improved treatment and health service organisation from that of screening, which would bias our results in favour of screening. There will also be some contamination of post-screening mortality from breast cancer diagnosed prior to screening, beyond our attempts to adjust for delayed benefit. This would bias against screening. However, our estimates from publicly available data suggest considerably lower benefits than estimates based on comparison of screened versus non-screened women.Jari HaukkaGraham ByrnesMathieu BoniolPhilippe AutierPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 9, p e22422 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jari Haukka Graham Byrnes Mathieu Boniol Philippe Autier Trends in breast cancer mortality in Sweden before and after implementation of mammography screening.
description	<h4>Background</h4>Incidence-based mortality modelling comparing the risk of breast cancer death in screened and unscreened women in nine Swedish counties has suggested a 39% risk reduction in women 40 to 69 years old after introduction of mammography screening in the 1980s and 1990s.<h4>Objective</h4>We evaluated changes in breast cancer mortality in the same nine Swedish counties using a model approach based on official Swedish breast cancer mortality statistics, robust to effects of over-diagnosis and treatment changes. Using mortality data from the NordCan database from 1974 until 2003, we estimated the change in breast cancer mortality before and after introduction of mammography screening in at least the 13 years that followed screening start.<h4>Results</h4>Breast mortality decreased by 16% (95% CI: 9 to 22%) in women 40 to 69, and by 11% (95% CI: 2 to 20%) in women 40 to 79 years of age.<h4>Discussion</h4>Without individual data it is impossible to completely separate the effects of improved treatment and health service organisation from that of screening, which would bias our results in favour of screening. There will also be some contamination of post-screening mortality from breast cancer diagnosed prior to screening, beyond our attempts to adjust for delayed benefit. This would bias against screening. However, our estimates from publicly available data suggest considerably lower benefits than estimates based on comparison of screened versus non-screened women.
format	article
author	Jari Haukka Graham Byrnes Mathieu Boniol Philippe Autier
author_facet	Jari Haukka Graham Byrnes Mathieu Boniol Philippe Autier
author_sort	Jari Haukka
title	Trends in breast cancer mortality in Sweden before and after implementation of mammography screening.
title_short	Trends in breast cancer mortality in Sweden before and after implementation of mammography screening.
title_full	Trends in breast cancer mortality in Sweden before and after implementation of mammography screening.
title_fullStr	Trends in breast cancer mortality in Sweden before and after implementation of mammography screening.
title_full_unstemmed	Trends in breast cancer mortality in Sweden before and after implementation of mammography screening.
title_sort	trends in breast cancer mortality in sweden before and after implementation of mammography screening.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/1705a1876fae4295b33763883637fc56
work_keys_str_mv	AT jarihaukka trendsinbreastcancermortalityinswedenbeforeandafterimplementationofmammographyscreening AT grahambyrnes trendsinbreastcancermortalityinswedenbeforeandafterimplementationofmammographyscreening AT mathieuboniol trendsinbreastcancermortalityinswedenbeforeandafterimplementationofmammographyscreening AT philippeautier trendsinbreastcancermortalityinswedenbeforeandafterimplementationofmammographyscreening
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Trends in breast cancer mortality in Sweden before and after implementation of mammography screening.

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