Test sensitivity of mammography and mean sojourn time over 40 years of breast cancer screening in Nijmegen (The Netherlands)

Aarts, Anne M W M; Duffy, Stephen W.; Geurts, S.M.E.; Vulkan, Daniel; Otten, J.D.M.; Hsu, CY; Chen, Chien-Jen; Verbeek, A.L.M.; Broeders, Mireille J. M.

doi:10.1177/0969141318814869

Cited by 18 publications

(29 citation statements)

References 29 publications

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“…Their MST seemed to be shorter than our estimates, because they only included high risk women for breast cancer. Compared with the MSTs from other observational studies for women aged 50 to 69 years from the Netherlands, Finland, Norway, and Canada, ranging from 2.02 to 7.00 years [18,[28][29][30], our results were far shorter, possibly due to different prevalence of dense breasts.…”

Section: Discussioncontrasting

confidence: 84%

“…The parametric methods derive incidence and prevalence data of the disease with assumption of a speci c distribution of sojourn time to estimate the MST. However, the method has been criticized due to its too constrained and underestimated screening intervals, occurred by the use of incidence data only [18]. In Korea, Lee et al adopted a derivative method from the parametric model to obtain the optimal screening intervals directly, suggesting 1.2-1.6, 1.0-1.6 and 1.8-1.9 years for women aged 40 to 49, 50 to 59, and 60 years and older, respectively [31].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, sensitivity has a direct relationship with the MST, because improved test sensitivity creates a longer MST due to the higher probability of detecting disease in the preclinical state. Sensitivity also can be deteriorated due to various factors, such as high breast density, that defer the starting point when screening can detect the disease [18]. Therefore, we simultaneously estimated the sensitivity of mammographic screening tests by specifying a probability of false-negative results (one minus sensitivity) in the modeling procedure [17].…”

Section: A Three-state Markov Modelmentioning

confidence: 99%

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Estimating Age-Specific Mean Sojourn Time of Breast Cancer and Sensitivity of Mammographic Screening by Breast Density among Korean Women

Choi¹,

Suh²,

Jung³

et al. 2021

Preprint

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Background: High breast cancer incidence among women in forties are specific to Asian, implicating dense breast. This study examined the natural history of breast cancer progression among Korean women according to the levels of breast density.Methods: We applied a three-state Markov model to fit the natural history of breast cancer to data in the Korean National Cancer Screening Program. Diagnosis of breast cancer was ascertained by linkage to the Korean Central Cancer Registry. Disease progression rates (i.e., transition rates from healthy to preclinical state, and from preclinical to clinical state) were estimated across levels of breast density determined by the Breast Imaging, Reporting and Data System (BI-RADS). Preclinical incidence of breast cancer, mean sojourn time (MST) and mammographic screening sensitivity were simultaneously generated in the model.Results: Overall prevalence of dense breast among Korean women was 53.9%, which declined with age. Transition rate from healthy to preclinical state, indicating the preclinical incidence of breast cancer, was estimated to be higher among women aged 40-49 years (0.0019, 95% CI; 0.0017-0.0021) and women aged 50-59 years (0.0020, 95% CI; 0.0017-0.0022), than older women aged 60-69 years (0.0014, 95% CI; 0.0012-0.0017). Transition rate from preclinical to clinical state was also fastest among younger age groups, which directly translated to the shortest MSTs, estimated as 1.98 (95% CI; 1.67-2.33), 2.49 (95% CI; 1.92-3.22) and 3.07 (95% CI; 2.11-4.46) years for women in forties, fifties and sixties, respectively. The sensitivity of the mammographic screening was higher among older women (0.70, 95% CI; 0.62-0.77) than women in fifties (0.65, 95% CI; 0.62-0.77) and women in forties (0.61, 95% CI; 0.54-0.61). Having dense breasts increased the likelihood of the preclinical cancer risk (1.96 to 2.35 times) and decreased the duration of MST (1.53 to 2.02 times).Conclusions: Korean women showed 1.5 to 2 times higher prevalence of dense breast tissues, compared to Western women. This study estimated Korean-specific parameters for the natural history of breast cancer that would be utilized for establishing optimal screening strategies in countries with higher dense breast prevalence.

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Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: A Three-state Markov Modelmentioning

confidence: 99%

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Estimating Age-Specific Mean Sojourn Time of Breast Cancer and Sensitivity of Mammographic Screening by Breast Density among Korean Women

Choi¹,

Suh²,

Jung³

et al. 2021

Preprint

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“…Most cancers take several years to become clinically evident. The sojourn time in the pre-clinical stage is several years for most common cancers (ranging from approximately 2 years for lung cancer to approximately 12 years for prostate cancer [ 10 , 11 , 12 , 13 ]). Therefore, a large proportion of cancers diagnosed during the follow-up of the VITAL study, especially cancers diagnosed in the early years of follow-up, likely were present but undiagnosed at the time of recruitment.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Advanced Cancer by Vitamin D3 Supplementation: Interaction by Body Mass Index Revisited

et al. 2021

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Meta-analyses of randomized controlled trials (RCTs) have demonstrated a protective effect of vitamin D3 (cholecalciferol) supplementation against cancer mortality. In the VITAL study, a RCT including 25,871 men ≥ 50 years and women ≥ 55 years, protective effects of vitamin D3 supplementation (2000 IU/day over a median of 5.3 years) with respect to incidence of any cancer and of advanced cancer (metastatic cancer or cancer death) were seen for normal-weight participants but not for overweight or obese participants. We aimed to explore potential reasons for this apparent variation of vitamin D effects by body mass index. We conducted complementary analyses of published data from the VITAL study on the association of body weight with cancer outcomes, stratified by vitamin D3 supplementation. Significantly increased risks of any cancer and of advanced cancer were seen among normal-weight participants compared to obese participants in the control group (relative risk (RR), 1.27; 95% confidence interval (CI), 1.07–1.52, and RR, 1.44; 95% CI, 1.04–1.97, respectively). No such patterns were seen in the intervention group. Among those with incident cancer, vitamin D3 supplementation was associated with a significantly reduced risk of advanced cancer (RR, 0.86; 95% CI, 0.74–0.99). The observed patterns point to pre-diagnostic weight loss of cancer patients and preventive effects of vitamin D3 supplementation from cancer progression as plausible explanations for the body mass index (BMI)—intervention interactions. Further research, including RCTs more comprehensively exploring the potential of adjuvant vitamin D therapy for cancer patients, should be pursued with priority.

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“…The two major interventions for which benefit may be time‐limited are surveillance and preventive medication. For surveillance, the lead‐time gained through the use of MRI, and the “sojourn time” of breast cancer, both have been estimated as under 5 years, 40,41 providing an interval over which the early detection value of MRI applies might apply. In contrast, the duration of benefit for preventive medication persists into the second decade after cessation of medication use 42,43 .…”

Section: Components Of a Comprehensive Breast Cancer Risk Assessment mentioning

confidence: 99%

Breast cancer risk assessment and management programs: A practical guide

et al. 2020

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Breast cancer risk assessment continues to evolve as emerging knowledge of breast cancer risk drivers and modifiers enables better identification of high‐risk women who may benefit from increased screening or targeted risk‐reduction protocols. The ongoing development of breast cancer Risk Assessment and Management Programs (RAMPs) presents an opportunity to decrease breast cancer disease incidence with evidence‐based interventions. The goal of this review was to provide a practical guide for providers seeking to establish or update a breast cancer risk assessment and management program. We outline genetic/familial, personal, reproductive, and lifestyle‐related factors while discussing the incorporation of risk modeling for precise risk estimate personalization. We further describe the process for determining a risk management plan: information gathering, generation of a risk profile, and articulation and implementation of risk reduction. We also include an overview of clinical workflows in breast cancer management programs and underlines the logistics of establishing a program as well as general principles for guiding the formulation of an individualized risk management plan. We discuss practical considerations, such as clinic structure and operation, allocation of resources, and patient education. Other critical aspects of program design, including identification of the target population, delineation of the core components of the clinical experience, definition of provider roles, description of referral mechanisms, and the launching of a marketing plan are also addressed. The process of risk assessment is both anxiety‐provoking and empowering for women at increased risk. New knowledge has enabled strategies to both understand the risk and control it through evidence‐based risk management. These benefits can now be realized by an increasing number of unaffected, high‐risk patients collaborating with risk management practitioners. Continuation of these efforts will lead to further progress in both risk stratification and risk management of women at elevated breast cancer risk in the near future.

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Test sensitivity of mammography and mean sojourn time over 40 years of breast cancer screening in Nijmegen (The Netherlands)

Cited by 18 publications

References 29 publications

Estimating Age-Specific Mean Sojourn Time of Breast Cancer and Sensitivity of Mammographic Screening by Breast Density among Korean Women

Estimating Age-Specific Mean Sojourn Time of Breast Cancer and Sensitivity of Mammographic Screening by Breast Density among Korean Women

Prevention of Advanced Cancer by Vitamin D3 Supplementation: Interaction by Body Mass Index Revisited

Breast cancer risk assessment and management programs: A practical guide

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