Summary
In March 1981, 40,318 women in Stockholm, aged 40–64, entered a randomized trial of breast cancer screening by single-view mammography alone versus no intervention in a control group of 20,000 women. The attendance rate during the first screening round was 81 per cent and the cancer detection rate was 4.0 per 1000 women. The detection the rate fell to 3.1 per 1000 in the second round, which was completed in October 1985. During 1986 the controlled design of the study was broken and the contro women were invited once to screening which was completed the same year. A total of 428 cases of breast cancer were thus diagnosed in the study group and 439 in the adjusted control group. After a mean follow-up of 7.4 years the number of breast cancer deaths in the study and control groups was 39 and 30 respectively. The relative risk of breast cancer death (screening versus control) was 0.71 (95 per cent confidence interval: 0.4–1.2). Among women older than 50 years at entry the relative risk was 0.57 (95 per cent confidence interval: 0.3–1.1). Cancer deaths among women under 50 were few and perhaps because of this no mortality reduction was seen in this age group. The estimate of mortality reduction lies between the results from two earlier Swedish randomized controlled trials.
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References
Shapiro S, Strax Ph, Venet L: Periodic breast cancer screening in reducing mortality from breast cancer. JAMA 215: 1777–1785, 1971
Colette HJA, Day NE, Rombach JJ, de Waard F: Evaluation of screening for breast cancer in a non-randomized study (the DOM-project) by means of a case-control study. Lancet i: 1224–1226, 1984
Verbeek ALM, Holland R, Sturmans F, Hendriks JHCL, Mravunac M, Day NE: Reduction of breast cancer mortality through mass screening with modern mammography. Lancet i: 1222–1224, 1984
UK Breast Cancer Detection Working Group: Trial of early detection of breast cancer: Description of method. Br J Cancer 44: 618–627, 1981
Chamberlain J, Coleman D, Ellman R, Moss SM: First results on mortality reduction in the UK trial of early detection of breast cancer. Lancet ii: 411–416, 1988
Roberts MM, Alexander FE, Anderson TJ, Chetty U, Donnan PT, Forrest P, Hepburn W, Huggins A, Kirkpatrick AE, Lamb J, Muir BB, Prescott RJ: Edinburgh trial of screening for breast cancer: mortality at seven years. Lancet 335: 241–246, 1990
Tabár L, Fagerberg G, Gad A, Baldetorp L, Holmberg LH, Gröntoft D, Ljungqvist U, Lundström B, Månsson IC, Eklund G, Pettersson F, Day NE: Reduction in mortality from breast cancer after mass screening with mammography. Lancet i: 829–832, 1985
Andersson I, Aspegren U, Janzon L, Landberg T, Lindholm K, Linell F, Ljungberg O, Ranstam J, Sigfüsson B: Mammographic screening and mortality from breast cancer: the Malmö mammographic screening trial. Br Med J 297: 943–948, 1988
Frisell J, Glas U, Hellström L, Somell A: Randomized mammographic screening for breast cancer in Stockholm. Breast Cancer Res Treat 8: 45–54, 1986
Frisell J, Eklund G, Hellström L, Glas U, Somell A: The Stockholm breast cancer screening trial — 5-year results and stage at discovery. Breast Cancer Res Treat 13: 79–87, 1989
World Health Organisation: Manual of international statistical classification of disease, injuries, and cases of death; based on the recommendations of the eighth revision conference, 1965, and adopted by the nineteenth world health assembly. Geneva: WHO, 1969
Tabár L, Gad A: Screening for breast cancer: The Swedish trial. Radiology 138: 219–222, 1981
Andersson I: Radiographic screening for breast carcinoma. Program and primary findings in 45–69 year old women. Acta Radiol (Diagn) 22: 185–194, 1981
Tabár L, Fagerberg G, Day NE, Holmberg L: What is the optimum interval between mammographic screening examinations? — An analysis based on the latest results of the Swedish two-county breast cancer screening trial. Br J Cancer 55: 547–551, 1987
Frisell J, Eklund G, Hellström L, Somell A: Analysis of interval breast carcinomas in a randomized screening trial in Stockholm. Breast Cancer Res Treat 9: 219–225, 1987
Gad A, Thomas BA, Moskowitz M: Screening for breast cancer in Europe: achivements, problems and future. Recent Results Cancer Res 90: 179–194, 1984
Rosen PP, Groshen S, Saigo PE, Kinne DW, Hellman S: A long-term follow-up study of survival in stage I (T1N0M0) and stage II (T1N1M0) breast carcinoma. J Clin Oncol 7: 355–366, 1989
Fournier O, Weber E, Hoeffken W, Baner M, Kubbi F, Barth V: Growth rate of 147 mammary carcinomas. Cancer 45: 2198–2207, 1980
Rutqvist LE, Wallgren A, Nilsson B: Is breast cancer a curable disease? A study of 14,731 women with breast cancer from the Cancer Registry of Norway. Cancer 53: 1793–1800, 1984
Tabár L, Gad A, Holmberg L, Ljungqvist U: Significant reduction in advanced breast cancer. Diagn Imag Clin Med 54: 158–164, 1985
Fagerberg G, Baldetorp L, Gröntoft O, Lundström B, Månsson JC, Nordenskjöld B: Effects of repeated mammographic screening on breast cancer stage distribution. Acta Radiologica 24: 465–473, 1985
Tabár L, Fagerberg CJG, Day NE: The results of periodic one-view mammography screening in a randomized, controlled trial in Sweden, Part 2: Evaluation of the results. In: Day NE, Miller AB (eds) Screening for breast cancer. UICC Technical Report Series, Geneva, 1988, pp 39–44
Tabár L, Fagerberg G, Duffy SW, Day NE: The Swedish two county trial of mammographic screening for breast cancer: recent results and calculations of benefit. J Epidemiol Community Health 43: 107–114, 1989
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Frisell, J., Eklund, G., Hellström, L. et al. Randomized study of mammography screening — preliminary report on mortality in the stockholm trial. Breast Cancer Res Tr 18, 49–56 (1991). https://doi.org/10.1007/BF01975443
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DOI: https://doi.org/10.1007/BF01975443