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Title:
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Cumulative risk of cancer detection in breast cancer screening by protocol strategy
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Author:
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Blanch, Jordi; Sala i Serra, Maria; Román Expósito, Marta; Ederra, M.; Salas, Dolores; Zubizarreta, Raquel; Sánchez-Jacob, Mercedes; Rué i Monné, Montserrat; Castells, Xavier
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Notes:
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Background There is little information on the
individual risk of screen-detected cancer in women over
successive participations. This study aimed to estimate the
10-year cumulative breast cancer detection risk (ductal
carcinoma in situ and invasive carcinoma) in a populationbased
breast cancer screening program according to distinct
protocol strategies. A further aim was to determine
which strategies maximized the cancer detection risk and
how this risk was affected by the radiologic protocol
variables. Methods Data were drawn from a retrospective
cohort of women from nine population-based screening
programs in Spain from 1990 to 2006. We used logistic regression with discrete intervals to estimate the cumulative
detection risk at 10 years of follow-up according to
radiologic variables and protocol strategies. Results In
women starting screening at the age of 45–59 years, the
cumulative risk of screen-detected cancer at 10 years ranged
from 11.11 to 16.71 per 1,000 participants according to
the protocol strategy. The cumulative detection risk for
overall cancer and invasive cancer was the highest with
strategies using digital mammography, double reading, and
two projections (16.71 and 12.07 %, respectively). For
ductal carcinoma in situ, cumulative detection risk was the
highest with strategies using screen-film, double reading,
and two projections (2.32 %). The risk was the lowest with
strategies using screen-film mammography, single reading,
and two projections. Conclusions This study found that at
least eleven cancers are detected per 1,000 women screened in the first 10 years of follow-up. Enhanced
knowledge of the variability in cumulative risk of screendetected
cancer could improve protocol strategies. |
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Subject(s):
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-Breast cancer
-Screening
-Cumulative risk |
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Rights:
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(c) Springer Verlag, 2013
info:eu-repo/semantics/restrictedAccess |
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Document type:
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article
publishedVersion |
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Published by:
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Springer Verlag
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