Beneficial effect of consecutive screening mammography examinations on mortality from breast cancer: A prospective study

TY - JOUR

T1 - Beneficial effect of consecutive screening mammography examinations on mortality from breast cancer

T2 - A prospective study

AU - Duffy, Stephen W.

AU - Tabár, László

AU - Yen, Amy Ming Fang

AU - Dean, Peter B.

AU - Smith, Robert A.

AU - Jonsson, Håkan

AU - Törnberg, Sven

AU - Chiu, Sherry Yueh Hsia

AU - Chen, Sam Li Sheng

AU - Jen, Grace Hsiao Hsuan

AU - Ku, May Mei Sheng

AU - Hsu, Chen Yang

AU - Ahlgren, Johan

AU - Maroni, Roberta

AU - Holmberg, Lars

AU - Chen, Tony Hsiu Hsi

N1 - Funding Information: Supported by the American Cancer Society through a gift from the Longaberger Company’s Horizon of Hope campaign (NHPDCSGBR-GBRLONG) and Bröstcancerförbundet, Sweden. Publisher Copyright: © 2021 Radiological Society of North America Inc.. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/6

Y1 - 2021/6

N2 - 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 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.

AB - 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 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.

UR - https://www.scopus.com/pages/publications/85105529822

U2 - 10.1148/radiol.2021203935

DO - 10.1148/radiol.2021203935

M3 - Article

C2 - 33650900

AN - SCOPUS:85105529822

SN - 0033-8419

VL - 299

SP - 541

EP - 547

JO - Radiology

JF - Radiology

IS - 3

ER -