Impact of mammographic screening and advanced cancer definition on the percentage of advanced-stage cancers in a steady-state breast screening programme in the Netherlands

Background To estimate the percentages of advanced-stage breast cancers (BCs) detected during the course of a steady-state screening programme when using different definitions of advanced BC. Methods Data of women aged 49-74 years, diagnosed with BC in 2006-2015, were selected from the Netherlands Cancer Registry and linked to the screening registry. BCs were classified as screen-detected, interval or non-screened. Three definitions of advanced BC were used for comparison: TNM stage (III-IV), NM stage (N+ and/or M+) and T size (invasive tumour >= 15 mm). Analyses were performed assuming a 1... Mehr ...

Verfasser: de Munck, Linda
Siesling, Sabine
Fracheboud, Jacques
den Heeten, Gerard J.
Broeders, Mireille J. M.
de Bock, Geertruida H.
Dokumenttyp: Artikel
Erscheinungsdatum: 2020
Reihe/Periodikum: de Munck , L , Siesling , S , Fracheboud , J , den Heeten , G J , Broeders , M J M & de Bock , G H 2020 , ' Impact of mammographic screening and advanced cancer definition on the percentage of advanced-stage cancers in a steady-state breast screening programme in the Netherlands ' , British Journal of Cancer , vol. 123 , no. 7 , pp. 1191-1197 . https://doi.org/10.1038/s41416-020-0968-6
Schlagwörter: OVERDIAGNOSIS / DENSITY / HARMS
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-26826589
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/d42ea1c8-82aa-4dc3-b7e1-2de8f3dd499a

Background To estimate the percentages of advanced-stage breast cancers (BCs) detected during the course of a steady-state screening programme when using different definitions of advanced BC. Methods Data of women aged 49-74 years, diagnosed with BC in 2006-2015, were selected from the Netherlands Cancer Registry and linked to the screening registry. BCs were classified as screen-detected, interval or non-screened. Three definitions of advanced BC were used for comparison: TNM stage (III-IV), NM stage (N+ and/or M+) and T size (invasive tumour >= 15 mm). Analyses were performed assuming a 10% overdiagnosis rate. In sensitivity analyses, this assumption varied from 0 to 30%. Results We included 46,734 screen-detected, 17,362 interval and 24,189 non-screened BCs. By TNM stage, 4.9% of screen-detected BCs were advanced, compared with 19.4% and 22.8% of interval and non-screened BCs, respectively (p <0.001). Applying the other definitions led to higher percentages of advanced BC being detected. Depending on the definition interval, non-screened BCs had a 2-5-times risk of being advanced. Conclusion Irrespective of the definition, screen-detected BCs were less frequently in the advanced stage. These findings provide evidence of a stage shift to early detection and support the potential of mammographic screening to reduce treatment-related burdens and the mortality associated with BC.