Rapid increase in incidence of breast ductal carcinoma in situ in Girona, Spain 1983–2007

Puig-Vives, Montserrat; Pollán, Marina; Rué, Montserrat; Osca-Gelis, Gemma; Sáez, Marc; Izquierdo, Àngel; Marcos‐Gragera, Rafael

doi:10.1016/j.breast.2012.01.014

Cited by 17 publications

(6 citation statements)

References 29 publications

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“…in the Girona province for the 2014-2015 cycle, which has reached the highest ever registered coverage and participation rates since its implementation, i.e., 81.86% and 71.39%, respectively [27]. Our study, with 7 years more worth of data than in Puig-vives et al [9], may have been able to capture these trends ( Figs. 1 and 2).…”

Section: Incidencementioning

confidence: 72%

“…Most DCIS are diagnosed by routine mammography. Indeed, its incidence has increased markedly since 1980 worldwide [2][3][4] mainly related to the spread use of opportunistic mammography and to the implementation of population-based screening programs [5][6][7][8][9]. It is estimated that over 20% of all screened detected BC are DCIS [5].…”

Section: Introductionmentioning

confidence: 99%

“…It is estimated that over 20% of all screened detected BC are DCIS [5]. Upward trends have been reported in several regions, including in the Girona province (Spain) where a marked increase, especially among women aged 50-69 years old, was observed between 1992 and 1996, attributed to the spread in mammography use in the region [9].…”

Section: Introductionmentioning

confidence: 99%

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Mortality of women with ductal carcinoma in situ of the breast: a population-based study from the Girona province, Spain (1994–2013)

et al. 2018

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Purpose We aim to comprehensively describe the incidence and mortality trends of ductal carcinoma in situ (DCIS) in the Girona province, Spain (1994 and to estimate the all-cause mortality excess risk of diagnosed women. Methods Age-standardized rates of DCIS were estimated between 1994 and 2013. Standard mortality ratios (SMR) and absolute excess mortality were calculated overall and by tumor and patient characteristics. A sensitivity analysis was conducted excluding cases with a subsequent invasive breast cancer (sIBC). Results Of the 641 women included, 56 died (follow-up time: 8.4 person-years). Between 1994 and 2013, a significant increase in incidence and decrease in mortality was identified among women aged between 50 and 69 years old. Neoplasms and circulatory system disease were the most common causes of death. No excess risk of death was found overall, except for women aged < 50 years (SMR = 3.44, 95% CI 1.85; 6.40) and those with a sIBC (SMR = 2.51, 95% CI 1.26; 5.02), risk that lessened when cases with sIBC were excluded. Patients with sIBC also showed an excess risk (SMR = 2.29, 95% CI 1.03; 5.10). Conclusions Among women aged 50-69 years old, incidence of DCIS has significantly increased yet mortality has decreased. Overall, the all-cause mortality risk of women diagnosed with DCIS remains similar to that of the general population except for women diagnosed before age 50 and those with sIBC, who showed a significant increased risk. Differential management of these patients should be considered.

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Section: Incidencementioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

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Mortality of women with ductal carcinoma in situ of the breast: a population-based study from the Girona province, Spain (1994–2013)

et al. 2018

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“…DCIS have substantially increased in the proportion of breast malignancies detected. The increase has been attributed to the implementation of breast cancer screening [21], [23]. It is estimated that DCIS represents 20% of screen detected breast malignancies [21], [24].…”

Section: Introductionmentioning

confidence: 99%

Trends in Detection of Invasive Cancer and Ductal Carcinoma In Situ at Biennial Screening Mammography in Spain: A Retrospective Cohort Study

Román

Rué

Sala³

et al. 2013

PLoS ONE

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BackgroundBreast cancer incidence has decreased in the last decade, while the incidence of ductal carcinoma in situ (DCIS) has increased substantially in the western world. The phenomenon has been attributed to the widespread adaption of screening mammography. The aim of the study was to evaluate the temporal trends in the rates of screen detected invasive cancers and DCIS, and to compare the observed trends with respect to hormone replacement therapy (HRT) use along the same study period.MethodsRetrospective cohort study of 1,564,080 women aged 45–69 years who underwent 4,705,681 screening mammograms from 1992 to 2006. Age-adjusted rates of screen detected invasive cancer, DCIS, and HRT use were calculated for first and subsequent screenings. Poisson regression was used to evaluate the existence of a change-point in trend, and to estimate the adjusted trends in screen detected invasive breast cancer and DCIS over the study period.ResultsThe rates of screen detected invasive cancer per 100.000 screened women were 394.0 at first screening, and 229.9 at subsequent screen. The rates of screen detected DCIS per 100.000 screened women were 66.8 at first screen and 43.9 at subsequent screens. No evidence of a change point in trend in the rates of DCIS and invasive cancers over the study period were found. Screen detected DCIS increased at a steady 2.5% per year (95% CI: 1.3; 3.8), while invasive cancers were stable.ConclusionDespite the observed decrease in breast cancer incidence in the population, the rates of screen detected invasive cancer remained stable during the study period. The proportion of DCIS among screen detected breast malignancies increased from 13% to 17% throughout the study period. The rates of screen detected invasive cancer and DCIS were independent of the decreasing trend in HRT use observed among screened women after 2002.

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“…No information is available regarding the extent of opportunistic screening in Granada province before or during our study period. However, this practice has been proved to be common in other countries [ 55 ], as well as in other regions of Spain before screening program introduction [ 56 , 57 ], and its effect over incidence trends have been considered in previous studies [ 45 , 64 ].…”

Section: Discussionmentioning

confidence: 99%

Trends in incidence, mortality and survival in women with breast cancer from 1985 to 2012 in Granada, Spain: a population-based study

et al. 2018

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BackgroundThe incidence of breast cancer has increased since the 1970s. Despite favorable trends in prognosis, the role of changes in clinical practice and the introduction of screening remain controversial. We examined breast cancer trends to shed light on their determinants.MethodsData were obtained for 8502 new cases of breast cancer in women between 1985 and 2012 from a population-based cancer registry in Granada (southern Spain), and for 2470 breast cancer deaths registered by the Andalusian Institute of Statistics. Joinpoint regression analyses of incidence and mortality rates were obtained. Observed and net survival rates were calculated for 1, 3 and 5 years. The results are reported here for overall survival and survival stratified by age group and tumor stage.ResultsOverall, age-adjusted (European Standard Population) incidence rates increased from 48.0 cases × 100,000 women in 1985–1989 to 83.4 in 2008–2012, with an annual percentage change (APC) of 2.5% (95%CI, 2.1–2.9) for 1985–2012. The greatest increase was in women younger than 40 years (APC 3.5, 95%CI, 2.4–4.8). For 2000–2012 the incidence trend increased only for stage I tumors (APC 3.8, 95%CI, 1.9–5.8). Overall age-adjusted breast cancer mortality decreased (APC − 1, 95%CI, − 1.4 – − 0.5), as did mortality in the 50–69 year age group (APC − 1.3, 95%CI, − 2.2 – − 0.4). Age-standardized net survival increased from 67.5% at 5 years in 1985–1989 to 83.7% in 2010–2012. All age groups younger than 70 years showed a similar evolution. Five-year net survival rates were 96.6% for patients with tumors diagnosed in stage I, 88.2% for stage II, 62.5% for stage III and 23.3% for stage IV.ConclusionsBreast cancer incidence is increasing – a reflection of the evolution of risk factors and increasing diagnostic pressure. After screening was introduced, the incidence of stage I tumors increased, with no decrease in the incidence of more advanced stages. Reductions were seen for overall mortality and mortality in the 50–69 year age group, but no changes were found after screening implementation. Survival trends have evolved favorably except for the 70–84 year age group and for metastatic tumors.

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Rapid increase in incidence of breast ductal carcinoma in situ in Girona, Spain 1983–2007

Cited by 17 publications

References 29 publications

Mortality of women with ductal carcinoma in situ of the breast: a population-based study from the Girona province, Spain (1994–2013)

Mortality of women with ductal carcinoma in situ of the breast: a population-based study from the Girona province, Spain (1994–2013)

Trends in Detection of Invasive Cancer and Ductal Carcinoma In Situ at Biennial Screening Mammography in Spain: A Retrospective Cohort Study

Trends in incidence, mortality and survival in women with breast cancer from 1985 to 2012 in Granada, Spain: a population-based study

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