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Beneficial Effect of Consecutive Screening Mammography Examinations on Mortality from Breast Cancer: A Prospective Study

Hsu Chen-Yang; Jonsson Håkan; Ahlgren Johan; Chen Tony Hsiu-Hsi; Smith Robert A; Yen Amy Ming-Fang; Holmberg Lars; Törnberg Sven; Dean Peter B; Chen Sam Li-Sheng; Duffy Stephen W; Jen Grace Hsiao-Hsuan; Tabár László; Maroni Roberta; Ku May Mei-Sheng; Chiu Sherry Yueh-Hsia

Beneficial Effect of Consecutive Screening Mammography Examinations on Mortality from Breast Cancer: A Prospective Study

Hsu Chen-Yang
Jonsson Håkan
Ahlgren Johan
Chen Tony Hsiu-Hsi
Smith Robert A
Yen Amy Ming-Fang
Holmberg Lars
Törnberg Sven
Dean Peter B
Chen Sam Li-Sheng
Duffy Stephen W
Jen Grace Hsiao-Hsuan
Tabár László
Maroni Roberta
Ku May Mei-Sheng
Chiu Sherry Yueh-Hsia
Katso/Avaa
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Radiological Society of North America, Inc.
doi:10.1148/radiol.2021203935
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Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2021093047933
Tiivistelmä


Background

Previously, the risk of death from breast cancer was analyzed for women participating versus those not participating in the last screening examination before breast cancer diagnosis. Consecutive attendance patterns may further refine estimates.


Purpose

To estimate the effect of participation in successive mammographic screening examinations on breast cancer mortality.


Materials and Methods

Participation data for Swedish women eligible for screening mammography in nine counties from 1992 to 2016 were linked with data from registries and regional cancer centers for breast cancer diagnosis, cause, and date of death (Uppsala University ethics committee registration number: 2017/147). Incidence-based breast cancer mortality was calculated by whether the women had participated in the most recent screening examination prior to diagnosis only (intermittent participants), the penultimate screening examination only (lapsed participants), both examinations (serial participants), or neither examination (serial nonparticipants). Rates were analyzed with Poisson regression. We also analyzed incidence of breast cancers proving fatal within 10 years.


Results

Data were available for a total average population of 549 091 women (average age, 58.9 years ± 6.7 [standard deviation]). The numbers of participants in the four groups were as follows: serial participants, 392 135; intermittent participants, 41 746; lapsed participants, 30 945; and serial nonparticipants, 84 265. Serial participants had a 49% lower risk of breast cancer mortality (relative risk [RR], 0.51; 95% CI: 0.48, 0.55; P < .001) and a 50% lower risk of death from breast cancer within 10 years of diagnosis (RR, 0.50; 95% CI: 0.46, 0.55; P < .001) than serial nonparticipants. Lapsed and intermittent participants had a smaller reduction. Serial participants had significantly lower risk of both outcomes than lapsed or intermittent participants. Analyses correcting for potential biases made little difference to the results.


Conclusion

Women participating in the last two breast cancer screening examinations prior to breast cancer diagnosis had the largest reduction in breast cancer death. Missing either one of the last two examinations conferred a significantly higher risk.

Published under a CC BY 4.0 license.

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