No overdiagnosis in the Norwegian Breast Cancer Screening Program estimated by combining record linkage and questionnaire information in the Norwegian Women and Cancer study
Method: For 124,978 women aged 49e79 years from the NOWAC study, information on screened women could be cross-validated from the NBCSP database. Based on information from the NOWAC questionnaire, unscreened women were further divided into those who had mammograms taken only outside the NBCSP and those who had never had taken a mammogram. Breast cancers diagnosed in 2005e2013 were identified through linkage to the Cancer Registry of Norway; in situ or DCIS 417; invasive 2845; combined 3262. Cumulative incidence rates (CIRs) for ages 49e79 years of breast cancer were compared using the log-rank test.
Results: After exclusion of women with a family history of breast cancer, screened women had a CIR of 9.7% for combined breast cancer, non-significantly lower compared with unscreened women. Screened women had a 1.1% increased CIR or 13.0% increased relative risk of breast cancer diagnosis (significant) compared with women who had never had a mammogram, but for invasive breast cancer alone the difference was reduced to -0.2% (95% CI: -9.1; 8.8). Invasive breast cancers were significantly smaller (<2.5 cm) in screened versus unscreened women. There was a borderline significant decrease in lymph node positive cancer among screened (p Z 0.06).
Conclusion: The findings of no significant overdiagnosis combined with smaller tumours and less lymph node metastases suggest that the prevailing view of overdiagnosis in the NBCSP should be challenged.
CitationLund, E., Nakamura, A. & Thalabard, J-C. (2018). No overdiagnosis in the Norwegian Breast Cancer Screening Program estimated by combining record linkage and questionnaire information in the Norwegian Women and Cancer study. European Journal of Cancer, 89, 102-112. https://doi.org/10.1016/j.ejca.2017.11.003
Showing items related by title, author, creator and subject.
Diet, dietary supplements and dietary change in cancer survivors and cancer-free persons : the Norwegian Women and Cancer study and the European Prospective Investigation into Cancer and Nutrition Skeie, Guri (Doctoral thesis; Doktorgradsavhandling, 2009-09-11)This thesis focuses on diet and dietary change in women who have breast or colorectal cancer, compared to cancer-free women in the Norwegian Women and Cancer study (NOWAC; Kvinner og kreft). The use of dietary supplements in the European Prospective Investigation into Cancer and Nutrition (EPIC) is also described. Finally, the association between use of cod liver oil and other supplements and survival ...
A comprehensive analysis of the androgen receptor gene and risk of breast cancer. Results from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3) Cox, David G.; Lund, Eiliv; Blanché, Hélène; Pearce, Celeste L.; Calle, Eugenia E.; Colditz, Graham A.; Pike, Malcolm C.; Albanes, Demetrius; Allen, Naomi E.; Amiano, Pilar; Berglund, Göran; Boeing, Heiner; Buring, Julie; Burtt, Noel; Canzian, Federico; Chanock, Stephen; Flavel-Chapelon, Françoise; Feigelson, Heather Spencer; Freedman, Matthew; Haiman, Christopher A.; Hankinson, Susan E.; Henderson, Brian E.; Hoover, Robert; Hunter, David J.; Kaaks, Rudolf; Kolonel, Laurence; Kraft, Peter; LeMarchand, Loic; Palli, Domenico; Peeters, Petra H.M.; Riboli, Elio; Stram, Daniel O.; Thun, Michael; Tjönneland, Anne; Trichopoulos, Dimitrios; Yeager, Meredith (Journal article; Tidsskriftartikkel; Peer reviewed, 2006-09-20)Introduction Androgens have been hypothesised to influence risk of breast cancer through several possible mechanisms, including their conversion to estradiol or their binding to the oestrogen receptor and/or androgen receptor (AR) in the breast. Here, we report on the results of a large and comprehensive study of the association between genetic variation in the AR gene and risk of breast cancer ...
Genetic polymorphisms of the GNRH1 and GNRHR genes and risk of breast cancer in the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3) Canzian, Federico; Lund, Eiliv; Kaaks, Rudolf; Cox, David G.; Henderson, Katherine D.; Henderson, Brian E.; Berg, Christine; Bingham, Sheila; Boeing, Heiner; Buring, Julie; Calle, Eugenia E.; Chanock, Stephen; Clavel-Chapelon, Francoise; Dossus, Laure; Feigelson, Heather Spencer; Haiman, Christopher A.; Hankinson, Susan E.; Hoover, Robert; Hunter, David J.; Isaacs, Claudine; Lenner, Per; Overvad, Kim; Palli, Domenico; Pearce, Celeste Leigh; Quiros, Jose R.; Riboli, Elio; Stram, Daniel O.; Thomas, Gilles; Thun, Michael J.; Trichopoulos, Dimitrios; van Gils, Carla H.; Ziegler, Regina G. (Journal article; Tidsskriftartikkel; Peer reviewed, 2009-07-29)Background: Gonadotropin releasing hormone (GNRH1) triggers the release of follicle stimulating hormone and luteinizing hormone from the pituitary. Genetic variants in the gene encoding GNRH1 or its receptor may influence breast cancer risk by modulating production of ovarian steroid hormones. We studied the association between breast cancer risk and polymorphisms in genes that code for GNRH1 ...