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Breast cancer mortality in Copenhagen after the introduction of mammography screening

Breast cancer mortality in Copenhagen after the introduction of mammography screening. Anne Helene Olsen Department of Epidemiology, University of Copenhagen a.h.olsen@pubhealth.ku.dk.

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Breast cancer mortality in Copenhagen after the introduction of mammography screening

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  1. Breast cancer mortality in Copenhagen after the introduction of mammography screening Anne Helene Olsen Department of Epidemiology, University of Copenhagen a.h.olsen@pubhealth.ku.dk • Denne præsentation vil sandsynligvis medføre diskussion blandt tilhørerne, hvilket vil resultere i handlingspunkter. Hvis du vil bruge PowerPoint til at holde styr på dem under præsentationen, skal du • Klikke med højre musknap i Diasvisning • Vælge “Referent” • Vælge fanen “Handlingspunkter” • Skrive handlingselementerne, efterhånden som de kommer frem • Klikke på OK for at slette denne boks • Derved oprettes der automatisk et dias med handlingspunkter sidst i præsentationen, hvor de punkter, du har noteret, vil stå.

  2. Danish programmes Screening of women aged 50-69 every second year Programmes cover 20% of Danish women aged 50-69 Fyn 1993: 50,000 women Copenhagen 1991: 40,000 women Frederiksberg 1994: 10,000 women

  3. Objective To estimate the effect of the Copenhagen mammography screening programme on breast cancer mortality

  4. Study and control groups Historical national control group Historical control group Study group National control group

  5. Methods Breast cancer mortality rates in the study group were compared with rates in the control groups, adjusting for age, period and region. Women were followed up from their first date of invitation to screening until death, emigration or end of follow-up. Refined mortality was used. Poisson regression was used for the analyses.

  6. Historical control group Historical national control group RR1:Region National control group Study group RR2:Region* screening Screening effect estimated by RR2/RR1 Do regional differences in pre-screening period reflect those of the screening period? If not: Screening effect confounded with region*period interaction

  7. Data sources • Mammography screening databases • Danish Cancer Register • Central Population Register • Cause of Death Register Linkage by personal identification number

  8. Results Historical control group Historical national control group RR 1.22 National control group Study group RR 0.91

  9. Results Estimated effect of participating in screening: RR 0.63 Estimated effect of being offered screening: RR 0.75 (95% C.I. 0.63-0.89)

  10. Regional differences time dependent? Since 1977: diagnostic and therapeutic strategies organised nationwide by Danish Breast Cancer Cooperative Group Breast cancer patients in study and control groups have been offered the same treatment

  11. Conclusion It has been possible within the Copenhagen mammography screening programme to reduce breast cancer mortality by an estimated 25% for women offered screening and 37% for women participating in screening

  12. Reference Olsen AH, Njor SH, Vejborg I, Schwartz W, Dalgaard P, Jensen M-B, Tange UB, Blichert-Toft M, Rank F, Mouridsen H, Lynge E. Breast cancer mortality in Copenhagen after introduction of mammography screening: cohort study. BMJ 2005; 330: 220-2.

  13. Financial support • Danish Medical Research Council • European Commission, DG Sanco • Danish Centre for Evaluation and Health Technology Assessment, Danish National Board of Health • Copenhagen Hospital Corporation

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