Abstract
BackgroundTo assess the impact of the participation in screening programme according to the mode of detection on the early diagnosis, treatment, and specific survival outcomes in women with breast cancer.MethodsWomen diagnosed with invasive breast cancer in Poitou-Charentes region (France) between 2008 and 2009 were classified into three groups, using data linkage of cancer registry, vital statistics and French organized screening programme: the screening programme (SP), interval cancer (IC), and non-screening programme detected cancer (NSP) groups. Specific survival rates were analysed using the Kaplan–Meier method and Cox proportional hazard models.ResultsAmong 1613 patients, 65.7% (n = 1059) participated in a screening programme. The interval cancer rate was 17.1% (n = 181). Tumours in the IC group were diagnosed at a more advanced stage, i.e. with further regional lymph node metastasis or local spread, than those in the SP group (p < 0.001), but with significantly fewer metastases at diagnosis than in the NSP group (p < 0.001). ICs underwent more aggressive primary treatments than the two other groups, with 28% of radical mastectomy and 67% undergoing chemotherapy. The five-year survival rate for IC group were 92.0% (95% CI, 89.9–94.0%).ConclusionsInterval cancers had more aggressive features than screen-detected cancers but were diagnosed at a less advanced stage compared to non-screen detected cancers. Despite having cancers missed by the screening programme, women who participate in the screening process seem to benefit from early treatment. These results must be confirmed with long-term follow-up.
Highlights
This study aimed to assess the impact of the participation in screening programme according to the mode of detection on the early diagnosis, treatment, and specific survival outcomes in women with breast cancer, using data linkage of cancer registry, vital statistics and French screening programme
As a majority of studies, we have found no significant differences in prognosis between women with interval cancer compared with an unscreened population, when taking into account the main prognostic factors [20,21,22,23,24,25]
Despite the aggressiveness of these cancers, women who participate in the screening process seem to benefit from early treatment
Summary
To assess the impact of the participation in screening programme according to the mode of detection on the early diagnosis, treatment, and specific survival outcomes in women with breast cancer. Breast cancer is the leading cause of cancer death in women worldwide [1]. To facilitate early detection and access to effective treatment of breast cancers, screening programmes have been implemented gradually in European countries [3] and have mostly demonstrated the effectiveness of screening in reducing breast cancer mortality [4,5,6,7,8,9]. In France, a screening programme was implemented nationwide since 2004, and offers a physical examination and a bilateral mammogram biennially to women aged 50–74 years. Ten years after its establishment, only slightly more than half of women (52.1% in 2014) participate, and 10% of women choose an individual (opportunistic) screening with a mammography performed under medical prescription, outside the official programme [14, 15].
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