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Effectiveness of early detection on breast cancer mortality reduction in Catalonia (Spain).
BMC Cancer 2009; 9:326BC

Abstract

BACKGROUND

At present, it is complicated to use screening trials to determine the optimal age intervals and periodicities of breast cancer early detection. Mathematical models are an alternative that has been widely used. The aim of this study was to estimate the effect of different breast cancer early detection strategies in Catalonia (Spain), in terms of breast cancer mortality reduction (MR) and years of life gained (YLG), using the stochastic models developed by Lee and Zelen (LZ).

METHODS

We used the LZ model to estimate the cumulative probability of death for a cohort exposed to different screening strategies after T years of follow-up. We also obtained the cumulative probability of death for a cohort with no screening. These probabilities were used to estimate the possible breast cancer MR and YLG by age, period and cohort of birth. The inputs of the model were: incidence of, mortality from and survival after breast cancer, mortality from other causes, distribution of breast cancer stages at diagnosis and sensitivity of mammography. The outputs were relative breast cancer MR and YLG.

RESULTS

Relative breast cancer MR varied from 20% for biennial exams in the 50 to 69 age interval to 30% for annual exams in the 40 to 74 age interval. When strategies differ in periodicity but not in the age interval of exams, biennial screening achieved almost 80% of the annual screening MR. In contrast to MR, the effect on YLG of extending screening from 69 to 74 years of age was smaller than the effect of extending the screening from 50 to 45 or 40 years.

CONCLUSION

In this study we have obtained a measure of the effect of breast cancer screening in terms of mortality and years of life gained. The Lee and Zelen mathematical models have been very useful for assessing the impact of different modalities of early detection on MR and YLG in Catalonia (Spain).

Authors+Show Affiliations

Biomedical Research Institut of Lleida (IRBLLEIDA), Lleida, Catalonia, Spain. montse.rue@cmb.udl.catNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19754959

Citation

Rue, Montserrat, et al. "Effectiveness of Early Detection On Breast Cancer Mortality Reduction in Catalonia (Spain)." BMC Cancer, vol. 9, 2009, p. 326.
Rue M, Vilaprinyo E, Lee S, et al. Effectiveness of early detection on breast cancer mortality reduction in Catalonia (Spain). BMC Cancer. 2009;9:326.
Rue, M., Vilaprinyo, E., Lee, S., Martinez-Alonso, M., Carles, M. D., Marcos-Gragera, R., ... Espinas, J. A. (2009). Effectiveness of early detection on breast cancer mortality reduction in Catalonia (Spain). BMC Cancer, 9, p. 326. doi:10.1186/1471-2407-9-326.
Rue M, et al. Effectiveness of Early Detection On Breast Cancer Mortality Reduction in Catalonia (Spain). BMC Cancer. 2009 Sep 15;9:326. PubMed PMID: 19754959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of early detection on breast cancer mortality reduction in Catalonia (Spain). AU - Rue,Montserrat, AU - Vilaprinyo,Ester, AU - Lee,Sandra, AU - Martinez-Alonso,Montserrat, AU - Carles,Misericor-Dia, AU - Marcos-Gragera,Rafael, AU - Pla,Roger, AU - Espinas,Josep-Alfons, Y1 - 2009/09/15/ PY - 2009/01/13/received PY - 2009/09/15/accepted PY - 2009/9/17/entrez PY - 2009/9/17/pubmed PY - 2009/12/16/medline SP - 326 EP - 326 JF - BMC cancer JO - BMC Cancer VL - 9 N2 - BACKGROUND: At present, it is complicated to use screening trials to determine the optimal age intervals and periodicities of breast cancer early detection. Mathematical models are an alternative that has been widely used. The aim of this study was to estimate the effect of different breast cancer early detection strategies in Catalonia (Spain), in terms of breast cancer mortality reduction (MR) and years of life gained (YLG), using the stochastic models developed by Lee and Zelen (LZ). METHODS: We used the LZ model to estimate the cumulative probability of death for a cohort exposed to different screening strategies after T years of follow-up. We also obtained the cumulative probability of death for a cohort with no screening. These probabilities were used to estimate the possible breast cancer MR and YLG by age, period and cohort of birth. The inputs of the model were: incidence of, mortality from and survival after breast cancer, mortality from other causes, distribution of breast cancer stages at diagnosis and sensitivity of mammography. The outputs were relative breast cancer MR and YLG. RESULTS: Relative breast cancer MR varied from 20% for biennial exams in the 50 to 69 age interval to 30% for annual exams in the 40 to 74 age interval. When strategies differ in periodicity but not in the age interval of exams, biennial screening achieved almost 80% of the annual screening MR. In contrast to MR, the effect on YLG of extending screening from 69 to 74 years of age was smaller than the effect of extending the screening from 50 to 45 or 40 years. CONCLUSION: In this study we have obtained a measure of the effect of breast cancer screening in terms of mortality and years of life gained. The Lee and Zelen mathematical models have been very useful for assessing the impact of different modalities of early detection on MR and YLG in Catalonia (Spain). SN - 1471-2407 UR - https://www.unboundmedicine.com/medline/citation/19754959/Effectiveness_of_early_detection_on_breast_cancer_mortality_reduction_in_Catalonia__Spain__ L2 - https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-9-326 DB - PRIME DP - Unbound Medicine ER -