14 years of follow-up from the Edinburgh randomised trial of breast-cancer screening
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| Název: | 14 years of follow-up from the Edinburgh randomised trial of breast-cancer screening |
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| Autoři: | Alexander, F E, Anderson, T J, Brown, H K, Forrest, A P M, Hepburn, W, Kirkpatrick, A E, Muir, B B, Prescott, R J, Smith, A |
| Zdroj: | Alexander, F E, Anderson, T J, Brown, H K, Forrest, A P M, Hepburn, W, Kirkpatrick, A E, Muir, B B, Prescott, R J & Smith, A 1999, ' 14 years of follow-up from the Edinbugh randomised trial of breast-cancer screening ', The Lancet, vol. 353, no. 9168, pp. 1903-1908 . |
| Informace o vydavateli: | Elsevier BV, 1999. |
| Rok vydání: | 1999 |
| Témata: | Scotland/epidemiology, Time Factors, Age Factors, Breast Neoplasms/mortality, Breast Neoplasms, Middle Aged, Breast Neoplasms/radiography, 3. Good health, Mass Screening/utilization, Cohort Studies, Survival Rate, Logistic Models, Scotland, Humans, Mass Screening, Female, Breast Neoplasms/prevention & control, Health Services Research, Mammography/utilization, Follow-Up Studies, Mammography |
| Popis: | The Edinburgh randomised trial of breast-cancer screening recruited women aged 45-64 years from 1978 to 1981 (cohort 1), and those aged 45-49 years during 1982-85 (cohorts 2 and 3). Results based on 14 years of follow-up and 270,000 woman-years of observation are reported.Breast-cancer mortality rates in the intervention group (28,628 women offered screening) were compared with those in the control group (26,026) with adjustment for socioeconomic status (SES) of general medical practices. Rate ratios were derived by means of logistic regression for the total trial population and for women first offered screening while younger than 50 years. Analyses were by intention to treat.Initial unadjusted results showed a difference of just 13% in breast-cancer mortality rates between the intervention and control groups (156 deaths [5.18 per 10,000] vs 167 [6.04 per 10,000]; rate ratio 0.87 [95% CI 0.70-1.06]), but the results were influenced by differences in SES by trial group. After adjustment for SES, the rate ratio was 0.79 (95% CI 0.60-1.02). When deaths after diagnosis more than 3 years after the end of the study were censored the rate ratio became 0.71 (0.53-0.95). There was no evidence of heterogeneity by age at entry and no evidence that younger entrants had smaller or delayed benefit (rate ratio 0.70 [0.41-1.20]). No breast-cancer mortality benefit was observed for women whose breast cancers were diagnosed when they were younger than 50 years. Other-cause mortality rates did not differ by trial group when adjusted for SES.Our findings confirm results from randomised trials in Sweden and the USA that screening for breast cancer lowers breast-cancer mortality. Similar results are reported by the UK geographical comparison, UK Trial of Early Detection of Breast Cancer. The results for younger women suggest benefit from introduction of screening before 50 years of age. |
| Druh dokumentu: | Article |
| Popis souboru: | application/pdf |
| Jazyk: | English |
| ISSN: | 0140-6736 |
| DOI: | 10.1016/s0140-6736(98)07413-3 |
| Přístupová URL adresa: | https://pubmed.ncbi.nlm.nih.gov/10371567 https://jglobal.jst.go.jp/en/detail?JGLOBAL_ID=200902182823644062 https://www.sciencedirect.com/science/article/pii/S0140673698074133 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(98)07413-3/fulltext https://www.research.ed.ac.uk/portal/files/13627390/14_years_of_follow_up_from_the_Edinbugh_randomised_trial_of_breast_cancer_screening.pdf https://www.ncbi.nlm.nih.gov/pubmed/10371567 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(98)07413-3/abstract https://www.pure.ed.ac.uk/ws/files/13627390/14_years_of_follow_up_from_the_Edinbugh_randomised_trial_of_breast_cancer_screening.pdf https://hdl.handle.net/20.500.11820/f772b8d1-7192-4bda-8350-fd654ced3de1 |
| Rights: | Elsevier TDM |
| Přístupové číslo: | edsair.doi.dedup.....fcd35505ee2705a3e2a1951ebcaecd63 |
| Databáze: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | The Edinburgh randomised trial of breast-cancer screening recruited women aged 45-64 years from 1978 to 1981 (cohort 1), and those aged 45-49 years during 1982-85 (cohorts 2 and 3). Results based on 14 years of follow-up and 270,000 woman-years of observation are reported.Breast-cancer mortality rates in the intervention group (28,628 women offered screening) were compared with those in the control group (26,026) with adjustment for socioeconomic status (SES) of general medical practices. Rate ratios were derived by means of logistic regression for the total trial population and for women first offered screening while younger than 50 years. Analyses were by intention to treat.Initial unadjusted results showed a difference of just 13% in breast-cancer mortality rates between the intervention and control groups (156 deaths [5.18 per 10,000] vs 167 [6.04 per 10,000]; rate ratio 0.87 [95% CI 0.70-1.06]), but the results were influenced by differences in SES by trial group. After adjustment for SES, the rate ratio was 0.79 (95% CI 0.60-1.02). When deaths after diagnosis more than 3 years after the end of the study were censored the rate ratio became 0.71 (0.53-0.95). There was no evidence of heterogeneity by age at entry and no evidence that younger entrants had smaller or delayed benefit (rate ratio 0.70 [0.41-1.20]). No breast-cancer mortality benefit was observed for women whose breast cancers were diagnosed when they were younger than 50 years. Other-cause mortality rates did not differ by trial group when adjusted for SES.Our findings confirm results from randomised trials in Sweden and the USA that screening for breast cancer lowers breast-cancer mortality. Similar results are reported by the UK geographical comparison, UK Trial of Early Detection of Breast Cancer. The results for younger women suggest benefit from introduction of screening before 50 years of age. |
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| ISSN: | 01406736 |
| DOI: | 10.1016/s0140-6736(98)07413-3 |