Population-based service mammography screening: the Icelandic experience

Kristjan Sigurdsson,1,3 Elínborg Jóna Ólafsdóttir,21The Icelandic Cancer Detection Clinic, 2The Icelandic Cancer Registry, Icelandic Cancer Society, 3Faculty of Medicine, University of Iceland, Reykjavik, IcelandObjective: This study analyzes the efficacy...

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Autores principales:	Sigurdsson K, &Oacute;lafsd&oacute;ttir EJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/8fb29323ab2c489690f46a1fe429c7d8
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spelling	oai:doaj.org-article:8fb29323ab2c489690f46a1fe429c7d82021-12-02T00:25:37ZPopulation-based service mammography screening: the Icelandic experience1179-1314https://doaj.org/article/8fb29323ab2c489690f46a1fe429c7d82013-05-01T00:00:00Zhttp://www.dovepress.com/population-based-service-mammography-screening-the-icelandic-experienc-a13011https://doaj.org/toc/1179-1314Kristjan Sigurdsson,1,3 Elínborg Jóna Ólafsdóttir,21The Icelandic Cancer Detection Clinic, 2The Icelandic Cancer Registry, Icelandic Cancer Society, 3Faculty of Medicine, University of Iceland, Reykjavik, IcelandObjective: This study analyzes the efficacy of the Icelandic population-based service mammography screening.Material and methods: Women aged 40–69 were invited for screening at 2-year intervals starting in November 1987. The study evaluates: (A) attendance and other screened performance parameters during 1998–2010; (B) trends in age-standardized and age-specific incidence rates during 1969–2010 and mortality rates during 1969–2010; and (C) distribution of risk factors and disease specific death rates according to mode of detection.Results: (A) In the age group of 40–69, the average 2-year attendance was 62%, recall rate was 4.1%, needle biopsy rate was 1.3%, surgery rate was 0.6%, invasive cancer rate was 0.4%, and ductal carcinoma in situ (DCIS) rate was 0.06%. (B) The linear incidence trend after the start of screening decreased significantly in the age group 40–49, increased significantly in the age group 50–69, but decreased non-significantly in the age group 70–79. The decreased age-specific incidence in the 70–79 age group was, however, greater than the increased age-specific incidence at the ages 50–69. The mortality rate decreased 41% for all age groups and the linear mortality trend decreased significantly at ages 40–49, 50–69, and 70–79. In the age group 40–74 years, the age-specific mortality decreased by 6.9 cases per 2000 during a 10-year period. (C) Screen-detected women had significantly smaller tumors, more favorable tumor grade, fewer axillary metastases and, after correction for other risk factors, the likelihood of dying from cancer decreased 54% (hazard ratio: 0.46; 95% confidence interval: 0.31–0.69) for these patients compared to cases of nonparticipators.Conclusion: The study results confirm acceptable rates of recalls and referrals for further diagnosis and treatment, and significantly decreased breast cancer mortality rate after starting screening.Keywords: mammography, screening, breast cancer, mortality, incidence, mode of detection, risk factorsSigurdsson K&Oacute;lafsd&oacute;ttir EJDove Medical PressarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast Cancer: Targets and Therapy, Vol 2013, Iss default, Pp 17-25 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Sigurdsson K &Oacute;lafsd&oacute;ttir EJ Population-based service mammography screening: the Icelandic experience
description	Kristjan Sigurdsson,1,3 Elínborg Jóna Ólafsdóttir,21The Icelandic Cancer Detection Clinic, 2The Icelandic Cancer Registry, Icelandic Cancer Society, 3Faculty of Medicine, University of Iceland, Reykjavik, IcelandObjective: This study analyzes the efficacy of the Icelandic population-based service mammography screening.Material and methods: Women aged 40–69 were invited for screening at 2-year intervals starting in November 1987. The study evaluates: (A) attendance and other screened performance parameters during 1998–2010; (B) trends in age-standardized and age-specific incidence rates during 1969–2010 and mortality rates during 1969–2010; and (C) distribution of risk factors and disease specific death rates according to mode of detection.Results: (A) In the age group of 40–69, the average 2-year attendance was 62%, recall rate was 4.1%, needle biopsy rate was 1.3%, surgery rate was 0.6%, invasive cancer rate was 0.4%, and ductal carcinoma in situ (DCIS) rate was 0.06%. (B) The linear incidence trend after the start of screening decreased significantly in the age group 40–49, increased significantly in the age group 50–69, but decreased non-significantly in the age group 70–79. The decreased age-specific incidence in the 70–79 age group was, however, greater than the increased age-specific incidence at the ages 50–69. The mortality rate decreased 41% for all age groups and the linear mortality trend decreased significantly at ages 40–49, 50–69, and 70–79. In the age group 40–74 years, the age-specific mortality decreased by 6.9 cases per 2000 during a 10-year period. (C) Screen-detected women had significantly smaller tumors, more favorable tumor grade, fewer axillary metastases and, after correction for other risk factors, the likelihood of dying from cancer decreased 54% (hazard ratio: 0.46; 95% confidence interval: 0.31–0.69) for these patients compared to cases of nonparticipators.Conclusion: The study results confirm acceptable rates of recalls and referrals for further diagnosis and treatment, and significantly decreased breast cancer mortality rate after starting screening.Keywords: mammography, screening, breast cancer, mortality, incidence, mode of detection, risk factors
format	article
author	Sigurdsson K &Oacute;lafsd&oacute;ttir EJ
author_facet	Sigurdsson K &Oacute;lafsd&oacute;ttir EJ
author_sort	Sigurdsson K
title	Population-based service mammography screening: the Icelandic experience
title_short	Population-based service mammography screening: the Icelandic experience
title_full	Population-based service mammography screening: the Icelandic experience
title_fullStr	Population-based service mammography screening: the Icelandic experience
title_full_unstemmed	Population-based service mammography screening: the Icelandic experience
title_sort	population-based service mammography screening: the icelandic experience
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/8fb29323ab2c489690f46a1fe429c7d8
work_keys_str_mv	AT sigurdssonk populationbasedservicemammographyscreeningtheicelandicexperience AT ampoacutelafsdampoacutettirej populationbasedservicemammographyscreeningtheicelandicexperience
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Population-based service mammography screening: the Icelandic experience

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