Abstract
OBJECTIVE: Assessing changes in breast cancer (BC) incidence and stage distribution in the District of Modena, Italy, during the period 1992–1998, and their relationship to a mammographic screening program launched in 1995.
METHODS: Demographic, clinical, and pathological data of all BC cases reported to the population-based Modena Cancer Registry between 1992 and 1998 were collected and linked to the screening database.
RESULTS: A total of 3429 women were diagnosed with BC in the District of Modena between 1992 and 1998. In this period the incidence rate increased by 15.7% (from 134.3 in 1992 to 155.4 per 100,000 in 1998). The increase began in 1995 and exclusively included women aged 50–69; the incidence rose by 30.4%. Moreover, the rise was confined to early tumors, with more than half (54%) of all cases reported in 1998 diagnosed as stage 0 or I disease, compared with 42% in 1992. Screen-detected tumors were significantly smaller (13.2 mm) than other tumors diagnosed in women aged 50–69 (18.5 mm), with 46% of screen-detected tumors smaller than 10 mm. Overall, a decline in the average tumor diameter was shown (from 20.2 mm in 1992–1994 to 18 mm in 1996–1998).
CONCLUSIONS: Our data confirm that mammographic screening leads to an increase in the incidence of early-stage BC cancers.
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References
Mettlin C (1999) Global breast cancer mortality statistics. CA Cancer J Clin 49: 138–144.
Federico M, Mangone L, Maiorana A, De Girolamo G (2001) I tumori in provincia di Modena nel biennio 1996–97. Modena: Progress.
Peto R, Boreham J, Clarke M, Davies C, Beral V (2000) UK and USA breast cancer deaths down 25% in year 2000 at ages 20–69 years. Lancet 355: 1822. Breast cancer incidence and mammographic screening 733
Howe HL, Wingo PA, Thun MJ, et al. (2001) Annual Report to the Nation on the Status of Cancer (1973 through 1998), featuring cancer with recent increasing trends. J Natl Cancer Inst 93: 824–842.
Coleman MP (2000) Trends in breast cancer incidence, survival and mortality. Lancet 356: 590–591.
Early Breast Cancer Trialists' Collaborative Group (1998) Tamoxifen for early breast cancer: an overview of randomised trials. Lancet 351: 1451–1467.
Early Breast Cancer Trialists' Collaborative Group (1998) Polichemotherapy for early breast cancer: an overview of the randomised trials. Lancet 352: 930–942.
Taba'r L, Fagerberg G, Gad A, et al. (1985) 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 1: 829–832.
Kierlikowske K, Grady D, Rubin SM, Sandrock C, Ernster V (1995) Efficacy of screening mammography. A meta-analysis. JAMA 273: 149–154.
Day ME, Williams DRR, Khaw KT (1989) Breast cancer screening programmes. The development of a monitoring and evaluation system. Br J Cancer 59: 954–958.
Ries LAG, Eisner MP, Kosary CL, et al. (2001) SEER Cancer Statistics Review, 1973–1998. Bethesda, MD: National Cancer Institute.
Barchielli A, Paci E (2001) Trends in breast cancer mortality, incidence and survival, and mammographic screening in Tuscany, Italy. Cancer Causes Control 12: 249–255.
Paci E, Ciatto S, Buiatti E, Cecchini S, Palli D, Rosselli del Turco M (1990) Early indicators of efficacy of breast cancer screening programmes. Results of the Florence Screening Programme. Int J Cancer 46: 198–202.
Parkin DM, Whelan SL, Ferlay J, et al. (1997) Cancer Incidence in Five Continents, Vol. VII. Lyon: International Agency for Research on Cancer; IARC Scientific Publication No. 143, pp. 542–545.
Sobin LH, Wittekind CH, eds. International Union Against Cancer. (1997) TNM Classification of Malignant Tumours, 5th edn. New York: Wiley.
Fagerberg G, Baldetorp L, Gro¨ ntoft O, Lundstro¨ m B, Månson JC, Nordenskjo¨ ld B (1985) Effects of repeated mammographic screening on breast cancer stage distribution. Acta Radiol 24: 465–473.
White E, Yul Lee C, Kristal AR (1990) Evaluation of the increase in breast cancer incidence in relation to mammography use. J Natl Cancer Inst 82: 1546–1552.
Lantz PM, Remington PL, Newcomb PA (1991) Mammography screening and increased incidence of breast cancer in Wisconsin. J Natl Cancer Inst 83: 1540–1546.
Quinn M, Allen E (1995) Changes in incidence and mortality from breast cancer in England and Wales since the introduction of screening. BMJ 311: 1391–1395.
Brewster D, Everington D, Harkness E, Gould A, Warner J (1996) Incidence and mortality from breast cancer since the introduction of screening. BMJ 312: 638–639.
McCann J, Wait S, Se´ radour B, Day N (1997) A comparison of the performance and impact of breast cancer screening programmes in East Anglia, U.K. and Bouches Du Rhône, France. Eur J Cancer 33: 429–435.
McCann J, Stockton D, Day N (1998) Breast cancer in East Anglia: the impact of the breast screening program on stage at diagnosis. J Med Screen 5: 42–48.
Harmer C, Staples M, Kavanagh AM (1999) Evaluation of breast cancer incidence: is the increase due entirely to mammographic screening? Cancer Causes Control 10: 333–337.
Fracheboud J, De Koning HJ, Beemsterboer PM, et al. (1998) Nation-wide breast cancer screening in the Netherlands: results of initial and subsequent screening 1990–1995. National Evaluation Teamfor Breast Cancer Screening. Int J Cancer 75: 694–698.
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Turchetti, D., Mangone, L., Negri, R. et al. Changes in breast cancer incidence and stage distribution in Modena, Italy: the effect of a mammographic screening program. Cancer Causes Control 13, 729–734 (2002). https://doi.org/10.1023/A:1020208719902
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DOI: https://doi.org/10.1023/A:1020208719902