Dataset Information

Impact of risk factors on different interval cancer subtypes in a population-based breast cancer screening programme.

ABSTRACT: BACKGROUND: Interval cancers are primary breast cancers diagnosed in women after a negative screening test and before the next screening invitation. Our aim was to evaluate risk factors for interval cancer and their subtypes and to compare the risk factors identified with those associated with incident screen-detected cancers. METHODS: We analyzed data from 645,764 women participating in the Spanish breast cancer screening program from 2000-2006 and followed-up until 2009. A total of 5,309 screen-detected and 1,653 interval cancers were diagnosed. Among the latter, 1,012 could be classified on the basis of findings in screening and diagnostic mammograms, consisting of 489 true interval cancers (48.2%), 235 false-negatives (23.2%), 172 minimal-signs (17.2%) and 114 occult tumors (11.3%). Information on the screening protocol and women's characteristics were obtained from the screening program registry. Cause-specific Cox regression models were used to estimate the hazard ratios (HR) of risks factors for interval cancer and incident screen-detected cancer. A multinomial regression model, using screen-detected tumors as a reference group, was used to assess the effect of breast density and other factors on the occurrence of interval cancer subtypes. RESULTS: A previous false-positive was the main risk factor for interval cancer (HR?=?2.71, 95%CI: 2.28-3.23); this risk was higher for false-negatives (HR?=?8.79, 95%CI: 6.24-12.40) than for true interval cancer (HR?=?2.26, 95%CI: 1.59-3.21). A family history of breast cancer was associated with true intervals (HR?=?2.11, 95%CI: 1.60-2.78), previous benign biopsy with a false-negatives (HR?=?1.83, 95%CI: 1.23-2.71). High breast density was mainly associated with occult tumors (RRR?=?4.92, 95%CI: 2.58-9.38), followed by true intervals (RRR?=?1.67, 95%CI: 1.18-2.36) and false-negatives (RRR?=?1.58, 95%CI: 1.00-2.49). CONCLUSION: The role of women's characteristics differs among interval cancer subtypes. This information could be useful to improve effectiveness of breast cancer screening programmes and to better classify subgroups of women with different risks of developing cancer.

SUBMITTER: Blanch J

PROVIDER: S-EPMC4204862 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Impact of risk factors on different interval cancer subtypes in a population-based breast cancer screening programme.

Blanch Jordi J Sala Maria M Ibáñez Josefa J Domingo Laia L Fernandez Belén B Otegi Arantza A Barata Teresa T Zubizarreta Raquel R Ferrer Joana J Castells Xavier X Rué Montserrat M Salas Dolores D

PloS one 20141021 10

<h4>Background</h4>Interval cancers are primary breast cancers diagnosed in women after a negative screening test and before the next screening invitation. Our aim was to evaluate risk factors for interval cancer and their subtypes and to compare the risk factors identified with those associated with incident screen-detected cancers.<h4>Methods</h4>We analyzed data from 645,764 women participating in the Spanish breast cancer screening program from 2000-2006 and followed-up until 2009. A total o ...[more]

PMID: 25333936

Similar Datasets

Project description:BackgroundDigital breast tomosynthesis (DBT) improves breast cancer (BC) detection compared to mammography, however, it is unknown whether this reduces interval cancer rate (ICR) at follow-up.MethodsUsing individual participant data (IPD) from DBT screening studies (identified via periodic literature searches July 2016 to November 2019) we performed an IPD meta-analysis. We estimated ICR for DBT-screened participants and the difference in pooled ICR for DBT and mammography-only screening, and compared interval BC characteristics. Two-stage meta-analysis (study-specific estimation, pooled synthesis) of ICR included random-effects, adjusting for study and age, and was estimated in age and density subgroups. Comparative screening sensitivity was calculated using screen-detected and interval BC data.FindingsFour prospective DBT studies, from European population-based programs, contributed IPD for 66,451 DBT-screened participants: age-adjusted pooled ICR was 13.17/10,000 (95%CI: 8.25-21.02). Pooled ICR was higher in the high-density (21.08/10,000; 95%CI: 6.71-66.27) than the low-density (8.63/10,000; 95%CI: 5.25-14.192) groups (P = 0.03) however estimates did not differ across age-groups (P = 0.32). Based on two studies that also provided data for 153,800 mammography screens (age-adjusted ICR 17.69/10,000; 95%CI: 13.22-23.66), DBT's pooled ICR was 16.83/10,000 (95%CI: 11.89-23.82). Comparative meta-analysis showed a non-significant difference in ICR (-0.44/10,000; 95%CI: -11.00-10.11) and non-significant difference in screening sensitivity (6.79%; 95%CI: -0.73-14.87%) between DBT and DM but a significant pooled difference in cancer detection rate of 33.49/10,000 (95%CI: 23.88-43.10). Distribution of interval BC prognostic characteristics did not differ between screening modalities except that those occurring in DBT-screened participants were significantly more likely to be negative for axillary-node metastases (P = 0.005).InterpretationAlthough heterogeneity in ICR estimates and few datasets limit recommendations, there was no difference between DBT and mammography in pooled ICR despite DBT increasing cancer detection.

Project description:In the past decades, mortality due to breast cancer has declined considerably in Switzerland and other developed countries. The reasons for this decline remain controversial as several factors occurred almost simultaneously, including important advances in treatment approaches, breast cancer awareness and the introduction of mammography screening programmes in many European countries. In Switzerland, mammography screening programmes (MSPs) have existed in some regions for over 20 years but do not yet exist in others. This offers the possibility to analyse its effects with modern spatiotemporal methodology. We aimed to assess the spatiotemporal patterns and the effect of MSPs on breast cancer mortality.Switzerland.The study covers breast cancer deaths of the female population of Switzerland during the period 1969-2012. We retrieved data from the Swiss Federal Statistical Office aggregated on a small-area level.We fitted Bayesian hierarchical spatiotemporal models on death rates indirectly standardised by national references. We used linguistic region, degree of urbanisation, duration of population-based screening programmes and socioeconomic index as covariates.In Switzerland, breast cancer mortality in women slightly increased until 1989-1992 and declined strongly thereafter. Until 2009-2012, the standardised mortality ratio declined to 57% (95% CI 54% to 60%) of the 1969-1972 value. None of the other coefficients of the spatial regressions had a significant effect on breast cancer mortality. In 2009-2012, no region had significantly elevated or reduced breast cancer mortality at 95%?credible interval level compared with the national mean.There has been a strong reduction of breast cancer mortality from the 1990s onwards. No important spatial disparities were observed. The factors studied (urbanisation, language, duration of population-based MSP and socioeconomic characteristics) did not seem to have an influence on them. Low participation rates and opportunistic screening use may have contributed to the low impact of MSPs.

Dataset Information

Impact of risk factors on different interval cancer subtypes in a population-based breast cancer screening programme.

Publications

Impact of risk factors on different interval cancer subtypes in a population-based breast cancer screening programme.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets