Overdiagnosis among women attending a population‐based mammography screening program. Issue 3 (25th February 2013)

• Record Type: Journal Article
• Authors: Falk, Ragnhild Sørum; Hofvind, Solveig; Skaane, Per; Haldorsen, Tor
• Is Part Of: International journal of cancer. Volume 133:Issue 3(2013:Aug. 01)
• Page Start: 705
• Page End: 712
• Publication Date: 2013-02-25
• Subjects: Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.28052
• Languages: English
• ISSNs: 0020-7136

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p>Increased incidence of ductal carcinoma <italic>in situ</italic> (DCIS) and invasive breast cancer (IBC) after introduction of organized screening has prompted debate about overdiagnosis. The aim was to examine the excess in incidence of DCIS and IBC during the screening period and the deficit after women left the program, and thereby to estimate the proportion of overdiagnosis. Women invited to the Norwegian Breast Cancer Screening Program were analyzed for DCIS or IBC during the period 1995–2009. Incidence rate ratios (IRRs) were calculated for attended <italic>vs</italic>. never attended women. The IRRs were adjusted by Mantel‐Haenszel (MH) method and applied to a set of reference rates and a reference population to estimate the proportion of overdiagnosis during the women's lifespan after the age of 50 years. A total of 702, 131 women were invited to the program. An excess of DCIS and IBC was observed among women who attended screening during the screening period; prevalently invited women aged 50–51 years had a MH IRR of 1.86 (95% CI 1.65–2.09) and subsequently invited women aged 52–69 years had a MH IRR of 1.56 (95% CI 1.45–1.68). In women aged 70–79 years, a deficit of 30% (MH IRR 0.70, 95% CI 0.62–0.80) was observed 1–10 years after they left the screening program. The estimated proportion of overdiagnosis varied from 10 to 20% depending on outcome and whether the women were invited or actually screened. The results highlight the need for individual data with longitudinal screening history and long‐term follow‐up as a basis for estimating overdiagnosis.</p> </abstract>