Immediate and delayed effects of mammographic screening on breast cancer mortality and incidence in birth cohorts

TM Ripping, ALM Verbeek, D van der Waal, JDM Otten, GJ den Heeten, Jacques Fracheboud, Harry de Koning, MJM Broeders

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6 Citations (Scopus)


Background: Trend studies investigating the impact of mammographic screening usually display age-specific mortality and incidence rates over time, resulting in an underestimate of the benefit of screening, that is, mortality reduction, and an overestimate of its major harmful effect, that is, overdiagnosis. This study proposes a more appropriate way of analysing trends. Methods: Breast cancer mortality (1950-2009) and incidence data (1975-2009) were obtained from Statistics Netherlands, 'Stg. Medische registratie' and the National Cancer Registry in the Netherlands for women aged 25-85 years. Data were visualised in age-birth cohort and age-period figures. Results: Birth cohorts invited to participate in the mammographic screening programme showed a deflection in the breast cancer mortality rates within the first 5 years after invitation. Thereafter, the mortality rate increased, although less rapidly than in uninvited birth cohorts. Furthermore, invited birth cohorts showed a sharp increase in invasive breast cancer incidence rate during the first 5 years of invitation, followed by a moderate increase during the following screening years and a decline after passing the upper age limit. Conclusion: When applying a trend study to estimate the impact of mammographic screening, we recommend using a birth cohort approach.
Original languageUndefined/Unknown
Pages (from-to)2467-2471
Number of pages5
JournalBritish Journal of Cancer
Issue number9
Publication statusPublished - 2013

Research programs

  • EMC NIHES-02-65-01

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