Improved Breast Cancer Survival Following Introduction of an Organized Mammography Screening Program among Both Screened and Unscreened Women: A Population-Based Cohort Study

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Improved Breast Cancer Survival Following Introduction of an Organized Mammography Screening Program among Both Screened and Unscreened Women: A Population-Based Cohort Study

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Title: Improved Breast Cancer Survival Following Introduction of an Organized Mammography Screening Program among Both Screened and Unscreened Women: A Population-Based Cohort Study
Author: Haldorsen, Tor; Hoff, Geir; Thoresen, Steinar O; Kalager, Mette; Bretthauer, Michael; Adami, Hans-Olov

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Citation: Kalager, Mette, Tor Haldorsen, Michael Bretthauer, Geir Hoff, Steinar O Thoresen, and Hans-Olov Adami. 2009. Improved breast cancer survival following introduction of an organized mammography screening program among both screened and unscreened women: a population-based cohort study. Breast Cancer Research : BCR 11(4): R44.
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Abstract: Introduction: Mammography screening reduces breast cancer mortality through earlier diagnosis but may convey further benefit if screening is associated with optimized treatment through multidisciplinary medical care. In Norway, a national mammography screening program was introduced among women aged 50 to 69 years during 1995/6 to 2004. Also during this time, multidisciplinary breast cancer care units were implemented. Methods: We constructed three cohorts of breast cancer patients: 1) the pre-program group comprising women diagnosed and treated before mammography screening began in their county of residence, 2) the post-program group comprising women diagnosed and treated through multidisciplinary breast cancer care units in their county but before they had been invited to mammography screening; and 3) the screening group comprising women diagnosed and treated after invitation to screening. We calculated Kaplan-Meier plots and multivariable Cox proportional hazard models. Results: We studied 41,833 women with breast cancer. The nine-year breast cancer-specific survival rate was 0.66 (95%CI: 0.65 to 0.67) in the pre-program group; 0.72 (95%CI: 0.70 to 0.74) in the post-program group; and 0.84 (95%CI: 0.80 to 0.88) in the screening group. In multivariable analyses, the risk of death from breast cancer was 14% lower in the post-program group than in the pre-program group (hazard ratio 0.86; (95%CI: 0.78 to 0.95, P = 0.003)). Conclusions: After nine years follow-up, at least 33% of the improved survival is attributable to improved breast cancer management through multidisciplinary medical care.
Published Version: doi://10.1186/bcr2331
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750103/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:4556039
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