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Does mammography reduce deaths from breast cancer?

A retrospective trend analysis of breast cancer mortality was performed within three pairs of neighbouring European countries (Northern Ireland (UK) v. Republic of Ireland, the Netherlands v. Belgium and Flanders (Belgian region south of the Netherlands), and Sweden v. Norway), in relation to implementation of screening. The information was retrieved from a WHO mortality database on cause of death and data sources on mammography screening, cancer treatment, and risk factors for breast cancer mortality.

Linear regressions of log-transformed, age-adjusted death rates were used to calculate changes in breast cancer mortality. Joinpoint analysis was used to identify the year when trends in mortality for all ages began to change.

From 1989 to 2006 deaths decreased in Northern Ireland and the Republic of Ireland by 29% and 26%; in the Netherlands, Belgium and Flanders by 25%, 20% and 25%; and in Sweden and Norway by 16% and 24%, respectively. The temporal trend and year of downward inflexion were comparable between Northern Ireland and the Republic of Ireland and between the Netherlands and Flanders. The mortality rates in Sweden have decreased steadily since 1972, showing no downward inflexion until 2006. Similar levels of health care services and prevalence of risk factors for breast cancer mortality were present in each pair of countries compared. However, implementation of mammography screening differed by a time interval of approximately 10 - 15 years.

From this analysis it was shown that the contrast between the time differences in implementation of mammography screening and the similarity in reductions in mortality between the country pairs suggested that screening did not play a direct part in the reductions in breast cancer mortality.

Autier P, et al. BMJ 2011; 343: d4411.
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Title Annotation:ABSTRACTS
Author:Farham, Bridget
Publication:CME: Your SA Journal of CPD
Geographic Code:4EUIR
Date:Aug 1, 2011
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