Breast cancer patients enrolled in the Swiss mammography screening program “donna” demonstrate prolonged survival
Journal
Breast Cancer Research
ISSN
1465-542X
Type
case review (law)
Date Issued
2024
Author(s)
;
;
;
;
Alena Eichenberger
;
Rudolf Morant
Editor(s)
Springer
Abstract
Study goal
We compared the survival rates of women with breast cancer (BC) detected within versus outside the mammography screening program (MSP) “donna”.
Methods
We merged data from the MSP with the data from corresponding cancer registries to categorize BC cases as within MSP (screen-detected and interval carcinomas) and outside the MSP. We analyzed the tumor stage distribution, tumor characteristics and the survival of the women. We further estimated hazard ratios using Cox-regressions to account for different characteristics between groups and corrected the survival rates for lead-time bias.
Results
We identified 1057 invasive (ICD-10: C50) and in-situ (D05) BC cases within the MSP and 1501 outside the MSP between 2010 and 2019 in the Swiss cantons of St. Gallen and Grisons. BC within the MSP had a higher share of stage I carcinoma (46.5% vs. 33.0%; < 0.01), a smaller (mean) tumor size (19.1 mm vs. 24.9 mm, < 0.01), and fewer recurrences and metastases in the follow-up period (6.7% vs. 15.6%, < 0.01). The 10-year survival rates were 91.4% for women within and 72.1% for women outside the MSP (< 0.05). Survival difference persisted but decreased when women within the same tumor stage were compared. Lead-time corrected hazard ratios for the MSP accounted for age, tumor size and Ki-67 proliferation index were 0.550 (95% CI 0.389, 0.778; for overall survival and 0.469 (95% CI 0.294, 0.749; < 0.01) for BC related survival.
Conclusion
Women participating in the “donna” MSP had a significantly higher overall and BC related survival rate than women outside the program. Detection of BC at an earlier tumor stage only partially explains the observed differences.
We compared the survival rates of women with breast cancer (BC) detected within versus outside the mammography screening program (MSP) “donna”.
Methods
We merged data from the MSP with the data from corresponding cancer registries to categorize BC cases as within MSP (screen-detected and interval carcinomas) and outside the MSP. We analyzed the tumor stage distribution, tumor characteristics and the survival of the women. We further estimated hazard ratios using Cox-regressions to account for different characteristics between groups and corrected the survival rates for lead-time bias.
Results
We identified 1057 invasive (ICD-10: C50) and in-situ (D05) BC cases within the MSP and 1501 outside the MSP between 2010 and 2019 in the Swiss cantons of St. Gallen and Grisons. BC within the MSP had a higher share of stage I carcinoma (46.5% vs. 33.0%; < 0.01), a smaller (mean) tumor size (19.1 mm vs. 24.9 mm, < 0.01), and fewer recurrences and metastases in the follow-up period (6.7% vs. 15.6%, < 0.01). The 10-year survival rates were 91.4% for women within and 72.1% for women outside the MSP (< 0.05). Survival difference persisted but decreased when women within the same tumor stage were compared. Lead-time corrected hazard ratios for the MSP accounted for age, tumor size and Ki-67 proliferation index were 0.550 (95% CI 0.389, 0.778; for overall survival and 0.469 (95% CI 0.294, 0.749; < 0.01) for BC related survival.
Conclusion
Women participating in the “donna” MSP had a significantly higher overall and BC related survival rate than women outside the program. Detection of BC at an earlier tumor stage only partially explains the observed differences.
Volume
26
Number
1
Division(s)