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

Cancer - Tập 119 Số 11 - Trang 2022-2028 - 2013
Flavia Foca1, Silvia Mancini1, Lauro Bucchi1, Donella Puliti2, Marco Zappa2, Carlo Naldoni3, Fabio Falcini1, Maria Letizia Gambino4, Silvano Piffer5, Maria E. Sanoja Gonzalez6, Fabrizio Stracci7, Manuel Zorzi8, Euǵenio Paci2
1Romagna Cancer Registry Romagna Cancer Institute Meldola Forli Italy
2Clinical and Descriptive Epidemiology Unit Cancer Prevention and Research Institute Florence Italy
3Department of Health Emilia‐Romagna Region Bologna Italy
4Epidemiology Unit Varese Health Care District Varese Italy
5Epidemiology Unit and Cancer Registry Trento Italy
6Epidemiology Unit and Cancer Registry Sondrio Health Care District Sondrio Italy
7Department of Medical‐Surgical Specialties and Public Health University of Perugia Perugia Italy
8Veneto Cancer Registry Veneto Oncology Institute Institute for Cancer Research and Treatment Padova Italy

Tóm tắt

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, age‐standardized (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.

CONCLUSIONS

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;119:2022–2028. © 2013 American Cancer Society.

Từ khóa


Tài liệu tham khảo

Tabar L, 1992, Update of the Swedish 2‐county program of mammographic screening for breast cancer, Radiol Clin North Am., 30, 187, 10.1016/S0033-8389(22)02494-0

10.1038/bjc.1989.203

10.1186/1471-2458-8-38

10.1136/jms.5.1.42

10.1136/jms.5.1.37

10.1136/jms.9.3.120

10.1038/sj.bjc.6602075

10.1002/(SICI)1097-0215(19990611)81:6<877::AID-IJC7>3.0.CO;2-F

10.1080/02841860701518041

10.1186/bcr3091

10.1002/ijc.11032

10.1023/A:1008949819969

10.1177/107327480401100403

10.1023/A:1014302121094

Zappa M, 2011, The diffusion of screening programmes in Italy, year 2009, Epidemiol Prev., 35, 1

10.1186/bcr1625

10.1038/sj.bjc.6603405

10.1038/sj.bjc.6604532

Anttila A, 2001, Evaluation and Monitoring of Screening Programmes, 77

10.1002/ijc.21228

10.1016/j.amjsurg.2008.07.052

10.1007/s10549-008-9913-8

Broeders M, 2006, European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis, 15

10.1258/jms.2008.007016

10.1093/annonc/mdq633