Effects of Repeated Mammographic Screening on Breast Cancer Stage Distribution: Results from a randomised study of 92 934 women in a Swedish county

Fagerberg, G; Baldetorp, L.; Gröntoft, Otto; Lundström, B; Månson, Jan-Christer; Nordenskjöld, Bo

doi:10.3109/02841868509134418

Cited by 60 publications

(17 citation statements)

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“…Only a few, who missed the first round attended the second. This is a high acceptance rate which is comparable with that of mammographic screening for breast cancer in Sweden ( 13) but much higher than the acceptance rate of only 12'%, from the German annual preventive check-up examination (14). A recent programme in the United Kingdom had a recruitment rate of 58% ( 12), however.…”

Section: Discussionmentioning

confidence: 50%

Repeated Screening for Carcinoma of the Prostate by Digital Rectal Examination in a Randomly Selected Population

Varenhorst

Carlsson²,

Capik³

et al. 1992

Acta Oncologica

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Section: Discussionmentioning

confidence: 50%

Repeated Screening for Carcinoma of the Prostate by Digital Rectal Examination in a Randomly Selected Population

Varenhorst

Carlsson²,

Capik³

et al. 1992

Acta Oncologica

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“…Second, because it was such an early study, the non-programmatic uptake of mammographic screening during the trial was low (7.5%) in the control arm, which, to a good approximation, can therefore be treated as unscreened. Third, a high proportion of women invited to screening took up the offer (89%), in contrast to the difficulties seen in other populations in getting women to go for routine screening (Fagerberg et al , 1985). Finally, the study design had two rounds of screening which allow the prevalence of existing cancers to be determined in the first round, whereas the second round provided information on the incidence of newly developed tumours.…”

Section: Discussionmentioning

confidence: 97%

“…In 1978, all women aged 40 years or more in the county of Ostergotland, Sweden, were randomised to either invitation to participate in screening or to what was then the standard care (no screening) (Fagerberg et al , 1985). Figure 1 (and Supplementary Material Table 7) outlines the observed screening pathway and detected tumour sizes.…”

Section: Methodsmentioning

confidence: 99%

“…( A ) Ten outcomes are marked in thickly bordered rectangles with tumour sizes, in order DCIS, ⩽10, 11–20, 21–50 and ⩾51 mm, underneath. Data were extracted from tables and text of Fagerberg et al (1985). The publication did not distinguish screening results at the second screen by attendance at the first screen: the merged data are provided in the dashed rectangles at the foot.…”

Section: Figurementioning

confidence: 99%

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Quantifying the natural history of breast cancer

et al. 2013

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Background:Natural history models of breast cancer progression provide an opportunity to evaluate and identify optimal screening scenarios. This paper describes a detailed Markov model characterising breast cancer tumour progression.Methods:Breast cancer is modelled by a 13-state continuous-time Markov model. The model differentiates between indolent and aggressive ductal carcinomas in situ tumours, and aggressive tumours of different sizes. We compared such aggressive cancers, that is, which are non-indolent, to those which are non-growing and regressing. Model input parameters and structure were informed by the 1978–1984 Ostergotland county breast screening randomised controlled trial. Overlaid on the natural history model is the effect of screening on diagnosis. Parameters were estimated using Bayesian methods. Markov chain Monte Carlo integration was used to sample the resulting posterior distribution.Results:The breast cancer incidence rate in the Ostergotland population was 21 (95% CI: 17–25) per 10 000 woman-years. Accounting for length-biased sampling, an estimated 91% (95% CI: 85–97%) of breast cancers were aggressive. Larger tumours, 21–50 mm, had an average sojourn of 6 years (95% CI: 3–16 years), whereas aggressive ductal carcinomas in situ took around half a month (95% CI: 0–1 month) to progress to the invasive ⩽10 mm state.Conclusion:These tumour progression rate estimates may facilitate future work analysing cost-effectiveness and quality-adjusted life years for various screening strategies.

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“…Mammography screening has increased the relative number of small breast carcinomas, as shown in the Swedish randomized trial of mammography screening in which 34% of the tumors were 10 mm or smaller. 2,3 The long term outcomes for patients with breast carcinoma are heavily dependent on tumor size. 4 The reported 7-year survival rate decreases from 96.3% for patients with tumors less than 2 cm to 45.5% for those with tumors greater than 5 cm.…”

mentioning

confidence: 99%