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Changes in breast cancer mortality in Navarre (Spain) after introduction of a screening programme.

Abstract

OBJECTIVE

The aim of this study was to assess changes in the trend of breast cancer mortality in Navarre, and the effect that a screening programme may have had on these changes.

METHODS

A breast cancer screening programme targeting women aged 45-65 years was launched in Navarre in September 1990. Breast cancer deaths between 1975 and 2004 were identified from the Navarre Mortality Registry, and the date of diagnosis was obtained by linkage with the population-based Navarre Cancer Registry. We compared breast cancer mortality during the pre-screening (1987-89) and screening (2002-04) periods, and with the estimated rate in the last period calculated by a linear model with a Poisson distribution. The long-term trends (from 1975 through 2004) were described by joinpoint regression analysis. Prevalent cases (those diagnosed before 1991) were excluded to minimize dilution of the benefit in the post-screening period due to deaths from tumours diagnosed before screening began.

RESULTS

The joinpoint analysis showed a rising trend in breast cancer mortality rates until 1994, followed by a continual decrease of just over 5% per year. A comparison of mortality rates between the last pre-screening and the screening periods showed a decrease of 36% (95% confidence interval [CI] 21-48%), with the largest reduction in the 50-69 years age group (52%; CI: 33-65%). In this age group, mortality in the 2002-04 period was 62% lower than that projected from extrapolation of the pre-screening trend, while in unscreened age groups (30-44 and > or =75 years), mortality was only 22% lower. When prevalent tumours were excluded, the 50-69 years age group presented a further decrease in mortality than when all tumours were considered.

CONCLUSIONS

Fourteen years after the introduction of a screening programme, a major reduction in breast cancer mortality has been observed.

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  • Authors+Show Affiliations

    ,

    Breast Cancer Screening Programme, Instituto de Salud Pública, Leyre 15, 31003 Pamplona, Spain. nascunce@cfnavarra.es

    , , , , ,

    Source

    Journal of medical screening 14:1 2007 pg 14-20

    MeSH

    Adult
    Age Distribution
    Aged
    Breast Neoplasms
    Carcinoma
    Female
    Humans
    Mass Screening
    Middle Aged
    Models, Statistical
    Spain

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    17362566

    Citation

    Ascunce, Elizaga N., et al. "Changes in Breast Cancer Mortality in Navarre (Spain) After Introduction of a Screening Programme." Journal of Medical Screening, vol. 14, no. 1, 2007, pp. 14-20.
    Ascunce EN, Moreno-Iribas C, Barcos Urtiaga A, et al. Changes in breast cancer mortality in Navarre (Spain) after introduction of a screening programme. J Med Screen. 2007;14(1):14-20.
    Ascunce, E. N., Moreno-Iribas, C., Barcos Urtiaga, A., Ardanaz, E., Ederra Sanz, M., Castilla, J., & Egüés, N. (2007). Changes in breast cancer mortality in Navarre (Spain) after introduction of a screening programme. Journal of Medical Screening, 14(1), pp. 14-20.
    Ascunce EN, et al. Changes in Breast Cancer Mortality in Navarre (Spain) After Introduction of a Screening Programme. J Med Screen. 2007;14(1):14-20. PubMed PMID: 17362566.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Changes in breast cancer mortality in Navarre (Spain) after introduction of a screening programme. AU - Ascunce,Elizaga N, AU - Moreno-Iribas,C, AU - Barcos Urtiaga,A, AU - Ardanaz,E, AU - Ederra Sanz,M, AU - Castilla,J, AU - Egüés,N, PY - 2007/3/17/pubmed PY - 2007/5/23/medline PY - 2007/3/17/entrez SP - 14 EP - 20 JF - Journal of medical screening JO - J Med Screen VL - 14 IS - 1 N2 - OBJECTIVE: The aim of this study was to assess changes in the trend of breast cancer mortality in Navarre, and the effect that a screening programme may have had on these changes. METHODS: A breast cancer screening programme targeting women aged 45-65 years was launched in Navarre in September 1990. Breast cancer deaths between 1975 and 2004 were identified from the Navarre Mortality Registry, and the date of diagnosis was obtained by linkage with the population-based Navarre Cancer Registry. We compared breast cancer mortality during the pre-screening (1987-89) and screening (2002-04) periods, and with the estimated rate in the last period calculated by a linear model with a Poisson distribution. The long-term trends (from 1975 through 2004) were described by joinpoint regression analysis. Prevalent cases (those diagnosed before 1991) were excluded to minimize dilution of the benefit in the post-screening period due to deaths from tumours diagnosed before screening began. RESULTS: The joinpoint analysis showed a rising trend in breast cancer mortality rates until 1994, followed by a continual decrease of just over 5% per year. A comparison of mortality rates between the last pre-screening and the screening periods showed a decrease of 36% (95% confidence interval [CI] 21-48%), with the largest reduction in the 50-69 years age group (52%; CI: 33-65%). In this age group, mortality in the 2002-04 period was 62% lower than that projected from extrapolation of the pre-screening trend, while in unscreened age groups (30-44 and > or =75 years), mortality was only 22% lower. When prevalent tumours were excluded, the 50-69 years age group presented a further decrease in mortality than when all tumours were considered. CONCLUSIONS: Fourteen years after the introduction of a screening programme, a major reduction in breast cancer mortality has been observed. SN - 0969-1413 UR - https://www.unboundmedicine.com/medline/citation/17362566/Changes_in_breast_cancer_mortality_in_Navarre__Spain__after_introduction_of_a_screening_programme_ L2 - http://journals.sagepub.com/doi/full/10.1258/096914107780154558?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -