Mammography screening and breast cancer mortality in New South Wales, Australia

Taylor, Richard, Morrell, Stephen, Estoesta, Jane and Brassil, Ann (2004) Mammography screening and breast cancer mortality in New South Wales, Australia. Cancer Causes & Control, 15 6: 543-550. doi:10.1023/B:CACO.0000036153.95908.f2


Author Taylor, Richard
Morrell, Stephen
Estoesta, Jane
Brassil, Ann
Title Mammography screening and breast cancer mortality in New South Wales, Australia
Journal name Cancer Causes & Control   Check publisher's open access policy
ISSN 0957-5243
1573-7225
Publication date 2004-08
Sub-type Article (original research)
DOI 10.1023/B:CACO.0000036153.95908.f2
Volume 15
Issue 6
Start page 543
End page 550
Total pages 8
Place of publication Oxford, UK
Publisher Kluwer
Language eng
Subject 11 Medical and Health Sciences
1117 Public Health and Health Services
Formatted abstract
Objective:
To investigate the relationship between utilisation of service mammography screening and breast cancer mortality in New South Wales (NSW) women.

Setting:

Population-based biennial mammography screening was progressively introduced in NSW from 1988, with active recruitment and re-invitation for women aged 50-69 years, and reached full geographic coverage by 1996. Biennial mammography screening participation has varied widely over time and by municipality.

Methods:
Breast cancer mortality by age, period and municipality was obtained from the NSW Central Cancer Registry. Biennial mammography screening rates for the same strata were obtained from the BreastScreen NSW database. Temporal changes in breast cancer mortality for NSW were summarised as annual average declines using Poisson regression. Breast cancer mortality for 1997-2001 was examined in relation to lagged biennial screening rates by municipality, adjusted for age, area socio-economic and geographic indicators, and breast cancer incidence, also using Poisson regression.

Results:
For the 50-69 year age group, the mean annual breast cancer mortality decline was 0.8% (not significant) for 1988-1994, and 4.4% (p < 0.0001) for 1995-2001. Statistically significant negative associations between breast cancer mortality in 1997-2001 and lagged biennial screening rates were found with the highest significance at a four-year lag for women aged 50-69 years (p = 0.0003) and also for women aged 50-79 years (p = 0.0002). From the regression coefficient, a 70% biennial screening rate is associated with 32% lower breast cancer mortality (compared to zero screening).

Conclusions:

The effect of population-based mammography screening on breast cancer mortality in NSW inferred using this method is consistent with results of trials and other service studies. This suggests that population-based mammography screening programs can achieve significant reductions in breast cancer mortality with adequate participation.
Keyword Oncology
Public, Environmental & Occupational Health
Breast Cancer
Evaluation
Mammography Screening
Mortality
Follow-up
Carcinoma Mortality
Randomized-trial
Survival
Women
Update
Rates
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Public Health Publications
 
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Created: Mon, 13 Aug 2007, 14:34:21 EST