Dataset Information


Effect of population breast screening on breast cancer mortality up to 2005 in England and Wales: an individual-level cohort study.

ABSTRACT: Population breast screening has been implemented in the UK for over 25 years, but the size of benefit attributable to such programmes remains controversial. We have conducted the first individual-based cohort evaluation of population breast screening in the UK, to estimate the impact of the NHS breast screening programme (NHSBSP) on breast cancer mortality.We followed 988?090 women aged 49-64 years in 1991 resident in England and Wales, who because of the staggered implementation of the NHSBSP, included both invited subjects and an uninvited control group. Individual-level breast screening histories were linked to individual-level mortality and breast cancer incidence data from national registers. Risk of death from breast cancer was investigated by incidence-based mortality analyses in relation to intention to screen and first round attendance. Overdiagnosis of breast cancer following a single screening round was also investigated.Invitation to NHSBSP screening was associated with a reduction in breast cancer mortality in 1991-2005 of 21% (RR=0.79, 95% CI: 0.73-0.84, P<0·001) after adjustment for age, socioeconomic status and lead-time. Breast cancer deaths among first invitation attenders were 46% lower than among non-attenders (RR=0.54, 95% CI: 0.51-0·57, P<0.001) and 32% lower following adjustment for age, socioeconomic status and self-selection bias (RR=0.68, 95% CI: 0.63-0·73, P<0.001). There was little evidence of overdiagnosis associated with invitation to first screen.The results indicate a substantial, statistically significant reduction in breast cancer mortality between 1991 and 2005 associated with NHSBSP activity. This is important in public health terms.


PROVIDER: S-EPMC5243996 | BioStudies | 2017-01-01T00:00:00Z

REPOSITORIES: biostudies

Similar Datasets

| S-EPMC7491203 | BioStudies
1000-01-01 | S-EPMC5489696 | BioStudies
2019-01-01 | S-EPMC6609127 | BioStudies
2013-01-01 | S-EPMC3817344 | BioStudies
1000-01-01 | S-EPMC3641428 | BioStudies
1000-01-01 | S-EPMC5414897 | BioStudies
2013-01-01 | S-EPMC3582341 | BioStudies
2016-01-01 | S-EPMC4839680 | BioStudies
1000-01-01 | S-EPMC5712859 | BioStudies
| S-EPMC5125086 | BioStudies