Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women

Background It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on th...

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Published in:Cancer Vol. 126; no. 13; pp. 2971 - 2979
Main Authors: Duffy, Stephen W., Tabár, László, Yen, Amy Ming‐Fang, Dean, Peter B., Smith, Robert A., Jonsson, Håkan, Törnberg, Sven, Chen, Sam Li‐Sheng, Chiu, Sherry Yueh‐Hsia, Fann, Jean Ching‐Yuan, Ku, May Mei‐Sheng, Wu, Wendy Yi‐Ying, Hsu, Chen‐Yang, Chen, Yu‐Ching, Svane, Gunilla, Azavedo, Edward, Grundström, Helene, Sundén, Per, Leifland, Karin, Frodis, Ewa, Ramos, Joakim, Epstein, Birgitta, Åkerlund, Anders, Sundbom, Ann, Bordás, Pál, Wallin, Hans, Starck, Leena, Björkgren, Annika, Carlson, Stina, Fredriksson, Irma, Ahlgren, Johan, Öhman, Daniel, Holmberg, Lars, Chen, Tony Hsiu‐Hsi
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01.07.2020
John Wiley and Sons Inc
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ISSN:0008-543X, 1097-0142, 1097-0142
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Abstract Background It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death. Methods Among 549,091 women, covering approximately 30% of the Swedish screening‐eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression. Results Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51‐0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66‐0.84 [P < .001]). Conclusions Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens. Substantial and significant reductions in the incidence rates of fatal breast cancer and advanced breast cancer with 10 years of follow‐up are observed in this analysis of greater than one‐half million Swedish women participating and not participating in breast cancer screening. These comparisons are contemporaneous, and thus are not influenced by changes in therapeutic regimens.
AbstractList Background It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death. Methods Among 549,091 women, covering approximately 30% of the Swedish screening‐eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression. Results Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51‐0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66‐0.84 [P < .001]). Conclusions Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens. Substantial and significant reductions in the incidence rates of fatal breast cancer and advanced breast cancer with 10 years of follow‐up are observed in this analysis of greater than one‐half million Swedish women participating and not participating in breast cancer screening. These comparisons are contemporaneous, and thus are not influenced by changes in therapeutic regimens.
Substantial and significant reductions in the incidence rates of fatal breast cancer and advanced breast cancer with 10 years of follow‐up are observed in this analysis of greater than one‐half million Swedish women participating and not participating in breast cancer screening. These comparisons are contemporaneous, and thus are not influenced by changes in therapeutic regimens.
Background: It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death. Methods: Among 549,091 women, covering approximately 30% of the Swedish screening‐eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression. Results: Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51‐0.68 [ P   &lt; .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66‐0.84 [ P   &lt; .001]). Conclusions: Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.
It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death.BACKGROUNDIt is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death.Among 549,091 women, covering approximately 30% of the Swedish screening-eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression.METHODSAmong 549,091 women, covering approximately 30% of the Swedish screening-eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression.Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51-0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66-0.84 [P < .001]).RESULTSWomen who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51-0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66-0.84 [P < .001]).Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.CONCLUSIONSSubstantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.
BackgroundIt is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death.MethodsAmong 549,091 women, covering approximately 30% of the Swedish screening‐eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression.ResultsWomen who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51‐0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66‐0.84 [P < .001]).ConclusionsSubstantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.
It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death. Among 549,091 women, covering approximately 30% of the Swedish screening-eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression. Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51-0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66-0.84 [P < .001]). Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.
Background It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death. Methods Among 549,091 women, covering approximately 30% of the Swedish screening-eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression. Results Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51-0.68 [P &lt; .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66-0.84 [P &lt; .001]). Conclusions Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.
Author Ramos, Joakim
Chen, Tony Hsiu‐Hsi
Fann, Jean Ching‐Yuan
Wallin, Hans
Carlson, Stina
Åkerlund, Anders
Bordás, Pál
Björkgren, Annika
Jonsson, Håkan
Ahlgren, Johan
Ku, May Mei‐Sheng
Epstein, Birgitta
Duffy, Stephen W.
Chiu, Sherry Yueh‐Hsia
Frodis, Ewa
Fredriksson, Irma
Grundström, Helene
Chen, Yu‐Ching
Wu, Wendy Yi‐Ying
Sundén, Per
Dean, Peter B.
Törnberg, Sven
Öhman, Daniel
Starck, Leena
Azavedo, Edward
Holmberg, Lars
Svane, Gunilla
Smith, Robert A.
Sundbom, Ann
Hsu, Chen‐Yang
Tabár, László
Chen, Sam Li‐Sheng
Yen, Amy Ming‐Fang
Leifland, Karin
AuthorAffiliation 6 Regional Cancer Center Umeå University Umeå Sweden
15 Orebro University Hospital Orebro Sweden
2 Department of Mammography Falun Central Hospital Falun Sweden
18 Sunderby Hospital Luleå Sweden
10 Graduate Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University Taipei City Taiwan
14 Västerås Central Hospital Västerås Sweden
20 Norrlands University Hospital Umeå Sweden
21 Regional Cancer Center, Uppsala University Hospital Uppsala Sweden
17 Karlstad Central Hospital Karlstad Sweden
9 Department of Nutrition and Health Sciences Kainan University Taoyuan City Taiwan
19 Sundsvall Hospital Sundsvall Sweden
5 Cancer Control Sciences American Cancer Society Atlanta Georgia
13 Sankt Göran Hospital Stockholm Sweden
16 Central Hospital Gavle Sweden
12 Danderyd Hospital Danderyd Sweden
22 Regional Cancer Center Stockholm-Gotland Stockholm Sweden
11 Taipei City Hospital Taipei City Taiwan
3 School of Oral Hygiene College of Oral Medicine Taipei Medical University Taip
AuthorAffiliation_xml – name: 1 Centre for Cancer Prevention Department of Epidemiology, Mathematics and Statistics Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry Queen Mary University of London London United Kingdom
– name: 12 Danderyd Hospital Danderyd Sweden
– name: 7 Karolinska Institute Karolinska University Hospital Stockholm Sweden
– name: 2 Department of Mammography Falun Central Hospital Falun Sweden
– name: 11 Taipei City Hospital Taipei City Taiwan
– name: 19 Sundsvall Hospital Sundsvall Sweden
– name: 13 Sankt Göran Hospital Stockholm Sweden
– name: 9 Department of Nutrition and Health Sciences Kainan University Taoyuan City Taiwan
– name: 8 Division of Biostatistics Institute of Preventive Medicine Chang Gung University Taoyuan City Taiwan
– name: 14 Västerås Central Hospital Västerås Sweden
– name: 3 School of Oral Hygiene College of Oral Medicine Taipei Medical University Taipei City Taiwan
– name: 5 Cancer Control Sciences American Cancer Society Atlanta Georgia
– name: 6 Regional Cancer Center Umeå University Umeå Sweden
– name: 15 Orebro University Hospital Orebro Sweden
– name: 21 Regional Cancer Center, Uppsala University Hospital Uppsala Sweden
– name: 22 Regional Cancer Center Stockholm-Gotland Stockholm Sweden
– name: 4 Diagnostic Radiology University of Turku Turku Finland
– name: 18 Sunderby Hospital Luleå Sweden
– name: 10 Graduate Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University Taipei City Taiwan
– name: 17 Karlstad Central Hospital Karlstad Sweden
– name: 23 Uppsala University Uppsala Sweden
– name: 16 Central Hospital Gavle Sweden
– name: 20 Norrlands University Hospital Umeå Sweden
Author_xml – sequence: 1
  givenname: Stephen W.
  surname: Duffy
  fullname: Duffy, Stephen W.
  email: s.w.duffy@qmul.ac.uk
  organization: Queen Mary University of London
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  givenname: László
  surname: Tabár
  fullname: Tabár, László
  organization: Falun Central Hospital
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  givenname: Amy Ming‐Fang
  surname: Yen
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  givenname: Peter B.
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  organization: University of Turku
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  givenname: Robert A.
  orcidid: 0000-0003-3344-2238
  surname: Smith
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  organization: American Cancer Society
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  givenname: Håkan
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  organization: Umeå University
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  givenname: Sven
  surname: Törnberg
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  organization: Karolinska University Hospital
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  givenname: Sam Li‐Sheng
  orcidid: 0000-0001-9750-3015
  surname: Chen
  fullname: Chen, Sam Li‐Sheng
  organization: Taipei Medical University
– sequence: 9
  givenname: Sherry Yueh‐Hsia
  surname: Chiu
  fullname: Chiu, Sherry Yueh‐Hsia
  organization: Chang Gung University
– sequence: 10
  givenname: Jean Ching‐Yuan
  surname: Fann
  fullname: Fann, Jean Ching‐Yuan
  organization: Kainan University
– sequence: 11
  givenname: May Mei‐Sheng
  surname: Ku
  fullname: Ku, May Mei‐Sheng
  organization: National Taiwan University
– sequence: 12
  givenname: Wendy Yi‐Ying
  surname: Wu
  fullname: Wu, Wendy Yi‐Ying
  organization: Umeå University
– sequence: 13
  givenname: Chen‐Yang
  surname: Hsu
  fullname: Hsu, Chen‐Yang
  organization: National Taiwan University
– sequence: 14
  givenname: Yu‐Ching
  surname: Chen
  fullname: Chen, Yu‐Ching
  organization: Taipei City Hospital
– sequence: 15
  givenname: Gunilla
  surname: Svane
  fullname: Svane, Gunilla
  organization: Karolinska University Hospital
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  givenname: Edward
  surname: Azavedo
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  organization: Karolinska University Hospital
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  givenname: Helene
  surname: Grundström
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  givenname: Per
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  fullname: Sundén, Per
  organization: Danderyd Hospital
– sequence: 19
  givenname: Karin
  surname: Leifland
  fullname: Leifland, Karin
  organization: Sankt Göran Hospital
– sequence: 20
  givenname: Ewa
  surname: Frodis
  fullname: Frodis, Ewa
  organization: Västerås Central Hospital
– sequence: 21
  givenname: Joakim
  surname: Ramos
  fullname: Ramos, Joakim
  organization: Västerås Central Hospital
– sequence: 22
  givenname: Birgitta
  surname: Epstein
  fullname: Epstein, Birgitta
  organization: Orebro University Hospital
– sequence: 23
  givenname: Anders
  surname: Åkerlund
  fullname: Åkerlund, Anders
  organization: Central Hospital
– sequence: 24
  givenname: Ann
  surname: Sundbom
  fullname: Sundbom, Ann
  organization: Karlstad Central Hospital
– sequence: 25
  givenname: Pál
  surname: Bordás
  fullname: Bordás, Pál
  organization: Sunderby Hospital
– sequence: 26
  givenname: Hans
  surname: Wallin
  fullname: Wallin, Hans
  organization: Sundsvall Hospital
– sequence: 27
  givenname: Leena
  surname: Starck
  fullname: Starck, Leena
  organization: Sundsvall Hospital
– sequence: 28
  givenname: Annika
  surname: Björkgren
  fullname: Björkgren, Annika
  organization: Norrlands University Hospital
– sequence: 29
  givenname: Stina
  surname: Carlson
  fullname: Carlson, Stina
  organization: Norrlands University Hospital
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  givenname: Irma
  surname: Fredriksson
  fullname: Fredriksson, Irma
  organization: Karolinska University Hospital
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  givenname: Johan
  surname: Ahlgren
  fullname: Ahlgren, Johan
  organization: Regional Cancer Center, Uppsala University Hospital
– sequence: 32
  givenname: Daniel
  surname: Öhman
  fullname: Öhman, Daniel
  organization: Stockholm-Gotland
– sequence: 33
  givenname: Lars
  surname: Holmberg
  fullname: Holmberg, Lars
  organization: Uppsala University
– sequence: 34
  givenname: Tony Hsiu‐Hsi
  orcidid: 0000-0002-5799-6705
  surname: Chen
  fullname: Chen, Tony Hsiu‐Hsi
  organization: National Taiwan University
BackLink https://www.ncbi.nlm.nih.gov/pubmed/32390151$$D View this record in MEDLINE/PubMed
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-423766$$DView record from Swedish Publication Index (Uppsala universitet)
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Issue 13
Keywords mortality
breast cancer
screening
fatality
mammography
Language English
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2020 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.
This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
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Special thanks are due to Sectra Medical Systems AB of Linkoping, Sweden, for painstaking informatics and the provision of essential population screening data. We also thank the women who participated in the screening and the staff of all the screening centers involved.
Stephen W. Duffy, László Tabár, Lars Holmberg, and Tony Hsiu‐Hsi Chen contributed equally to this article.
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Snippet Background It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in...
Substantial and significant reductions in the incidence rates of fatal breast cancer and advanced breast cancer with 10 years of follow‐up are observed in this...
It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer...
BackgroundIt is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast...
Background: It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in...
Background It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in...
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StartPage 2971
SubjectTerms Approximation
Breast cancer
Diagnosis
fatality
Health risk assessment
Health risks
Mammography
mortality
Oncology
Original
Reduction
Regression analysis
Risk
screening
Statistical analysis
Title Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women
URI https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fcncr.32859
https://www.ncbi.nlm.nih.gov/pubmed/32390151
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Volume 126
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