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BMC Cancer
Published in: BMC Cancer 1/2009

Open Access 01-12-2009 | Research article

Effectiveness of early detection on breast cancer mortality reduction in Catalonia (Spain)

Authors: Montserrat Rue, Ester Vilaprinyo, Sandra Lee, Montserrat Martinez-Alonso, Misericordia Carles, Rafael Marcos-Gragera, Roger Pla, Josep-Alfons Espinas

Published in: BMC Cancer | Issue 1/2009

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Abstract

Background

At present, it is complicated to use screening trials to determine the optimal age intervals and periodicities of breast cancer early detection. Mathematical models are an alternative that has been widely used. The aim of this study was to estimate the effect of different breast cancer early detection strategies in Catalonia (Spain), in terms of breast cancer mortality reduction (MR) and years of life gained (YLG), using the stochastic models developed by Lee and Zelen (LZ).

Methods

We used the LZ model to estimate the cumulative probability of death for a cohort exposed to different screening strategies after T years of follow-up. We also obtained the cumulative probability of death for a cohort with no screening. These probabilities were used to estimate the possible breast cancer MR and YLG by age, period and cohort of birth. The inputs of the model were: incidence of, mortality from and survival after breast cancer, mortality from other causes, distribution of breast cancer stages at diagnosis and sensitivity of mammography. The outputs were relative breast cancer MR and YLG.

Results

Relative breast cancer MR varied from 20% for biennial exams in the 50 to 69 age interval to 30% for annual exams in the 40 to 74 age interval. When strategies differ in periodicity but not in the age interval of exams, biennial screening achieved almost 80% of the annual screening MR. In contrast to MR, the effect on YLG of extending screening from 69 to 74 years of age was smaller than the effect of extending the screening from 50 to 45 or 40 years.

Conclusion

In this study we have obtained a measure of the effect of breast cancer screening in terms of mortality and years of life gained. The Lee and Zelen mathematical models have been very useful for assessing the impact of different modalities of early detection on MR and YLG in Catalonia (Spain).
Appendix
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Literature
1.
Olsen O, Gotzsche PC: Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2001, CD001877-4
2.
de Koning HJ: Mammographic screening: evidence from randomised controlled trials. Ann Oncol. 2003, 14: 1185-1189. 10.1093/annonc/mdg319.CrossRefPubMed
3.
Berry DA, Cronin KA, Plevritis SK, Fryback DG, Clarke L, Zelen M, Mandelblatt JS, Yakovlev AY, Habbema JD, Feuer EJ, Cancer Intervention and Surveillance Modeling Network (CISNET) Collaborators: Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med. 2005, 353: 1784-1792. 10.1056/NEJMoa050518.CrossRefPubMed
4.
Feuer E, Plevritis SK, Berry DA, Cronin KA, eds, Cancer Intervention and Surveillance Modeling Network (CISNET) Collaborators: The impact of mammography and adjuvant therapy on US breast cancer mortality (1975-2000): collective results from the Cancer Intervention and Surveillance modeling network. J Natl Cancer Inst Monogr. 2006, 1-126. 36
5.
Lee SJ, Zelen M: Mortality Modeling of Early Detection Programs. Biometrics. 2008, 64: 386-395. 10.1111/j.1541-0420.2007.00893.x.CrossRefPubMed
6.
Zelen M, Lee SJ: Models and the early detection of disease: methodological considerations. Cancer Treat Res. 2002, 113: 1-18.CrossRefPubMed
7.
Lee S, Zelen M: A stochastic model for predicting the mortality of breast cancer. J Natl Cancer Inst Monogr. 2006, 79-86. 36
8.
Lee SJ, Zelen M: Modelling the early detection of breast cancer. Ann Oncol. 2003, 14: 1199-1202. 10.1093/annonc/mdg323.CrossRefPubMed
9.
Lee S, Huang H, Zelen M: Early detection of disease and scheduling of screening examinations. Stat Methods Med Res. 2004, 13: 443-456. 10.1191/0962280204sm377ra.CrossRefPubMed
10.
Lee S, Zelen M: Scheduling periodic examinations for the early detection of disease: applications to breast cancer. J Am Stat Assoc. 1998, 1271-1281. 10.2307/2670042. 93
11.
Beemsterboer PMM, Warmerdam PG, Boer R, Borras JM, Moreno V, Viladiu P, de Konning HJ: Screening for breast cancer in Catalonia. Which policy is to be preferred?. Eur J Public Health. 1998, 8: 241-246. 10.1093/eurpub/8.3.241.CrossRef
12.
Holford TR: The estimation of age, period and cohort effects for vital rates. Biometrics. 1983, 39: 311-324. 10.2307/2531004.CrossRefPubMed
13.
14.
15.
McCullagh P, Nelder JA: Generalized linear models. 1983, Monographs on statistics and applied probability, London-New York: Chapman and HallCrossRef
16.
Rosenberg M: Competing risks to breast cancer mortality. J Natl Cancer Inst Monogr. 2006, 36: 15-9.CrossRefPubMed
17.
18.
19.
Vilaprinyo E, Gispert R, Martinez-Alonso M, Carles M, Pla R, Espinas JA, Rue M: Competing Risks to Breast Cancer Mortality in Catalonia. BMC Cancer. 2008, 8: 331-10.1186/1471-2407-8-331. doi:10.1186/1471-2407-8-331.CrossRefPubMedPubMedCentral
20.
Vilaprinyo E, Rue M, Marcos-Gragera R, Martinez-Alonso M: Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data. BMC Cancer. 2009, 9: 98-10.1186/1471-2407-9-98. doi:10.1186/1471-2407-9-98.CrossRefPubMedPubMedCentral
21.
Rue M, Carles M, Vilaprinyo E, Martinez-Alonso M, Espinas JA, Pla R, Brugulat P: Dissemination of periodic mammography and patterns of use, by birth cohort, in Catalonia (Spain). BMC Cancer. 2008, 8: 336-10.1186/1471-2407-8-336. doi:10.1186/1471-2407-8-336.CrossRefPubMedPubMedCentral
22.
Stout NK, Rosenberg MA, Trentham-Dietz A, Smith MA, Robinson SM, Fryback DG: Retrospective cost-effectiveness analysis of screening mammography. J Natl Cancer Inst. 2006, 98: 774-782.CrossRefPubMed
23.
Woo PP, Kim JJ, Leung GM: What is the most cost-effective population-based cancer screening program for Chinese women?. J Clin Oncol. 2007, 25: 617-624. 10.1200/JCO.2006.06.0210.CrossRefPubMed
24.
Gotzsche PC, Nielsen M: Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2006, CD001877-4
25.
Tabar L, Yen MF, Vitak B, Chen HH, Smith RA, Duffy SW: Mammography service screening and mortality in breast cancer patients: 20-year follow-up before and after introduction of screening. Lancet. 2003, 361: 1405-1410. 10.1016/S0140-6736(03)13143-1.CrossRefPubMed
26.
Tabar L, Fagerberg CJ, Gad A, Baldetorp L, Holmberg LH, Grontoft O, Ljungquist U, Lundstrom B, Manson JC, Eklund G: Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet. 1985, 1: 829-832. 10.1016/S0140-6736(85)92204-4.CrossRefPubMed
27.
Swedish Organised Service Screening Evaluation Group: Reduction in breast cancer mortality from organized service screening with mammography: 1. Further confirmation with extended data. Cancer Epidemiol Biomarkers Prev. 2006, 15: 45-51. 10.1158/1055-9965.EPI-05-0349.CrossRef
28.
Swedish Organised Service Screening Evaluation Group: Reduction in breast cancer mortality from the organised service screening with mammography: 2. Validation with alternative analytic methods. Cancer Epidemiol Biomarkers Prev. 2006, 15: 52-56. 10.1158/1055-9965.EPI-05-0953.CrossRef
29.
Anderson WF, Jatoi I, Devesa SS: Assessing the impact of screening mammography: Breast cancer incidence and mortality rates in Connecticut (1943-2002). Breast Cancer Res Treat. 2006, 99: 333-340. 10.1007/s10549-006-9214-z.CrossRefPubMed
30.
Holford TR, Cronin KA, Mariotto AB, Feuer EJ: Changing patterns in breast cancer incidence trends. J Natl Cancer Inst Monogr. 2006, 19-25. 36
31.
Blanchard K, Colbert JA, Kopans DB, Moore R, Halpern EF, Hughes KS, Smith BL, Tanabe KK, Michaelson JS: Long-term risk of false-positive screening results and subsequent biopsy as a function of mammography use. Radiology. 2006, 240: 335-342. 10.1148/radiol.2402050107.CrossRefPubMed
32.
Christiansen CL, Wang F, Barton MB, Kreuter W, Elmore JG, Gelfand AE, Fletcher SW: Predicting the cumulative risk of false-positive mammograms. J Natl Cancer Inst. 2000, 92: 1657-1666. 10.1093/jnci/92.20.1657.CrossRefPubMed
33.
Elmore JG, Barton MB, Moceri VM, Polk S, Arena PJ, Fletcher SW: Ten-year risk of false positive screening mammograms and clinical breast examinations. N Engl J Med. 1998, 338: 1089-1096. 10.1056/NEJM199804163381601.CrossRefPubMed
34.
Castells X, Molins E, Macia F: Cumulative false positive recall rate and association with participant related factors in a population based breast cancer screening programme. J Epidemiol Community Health. 2006, 60: 316-321. 10.1136/jech.2005.042119.CrossRefPubMedPubMedCentral
Metadata
Title
Effectiveness of early detection on breast cancer mortality reduction in Catalonia (Spain)
Authors
Montserrat Rue
Ester Vilaprinyo
Sandra Lee
Montserrat Martinez-Alonso
Misericordia Carles
Rafael Marcos-Gragera
Roger Pla
Josep-Alfons Espinas
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2009
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-9-326

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