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Assessing the impact of screening mammography: breast cancer incidence and mortality rates in Connecticut (1943–2002)

Breast Cancer Research and Treatment volume 99, pages 333–340 (2006)Cite this article

Abstract

Background

Randomized controlled studies demonstrate that early detection and intervention reduce breast cancer mortality by approximately 25%. Though the ultimate goal of screening is to reduce breast cancer deaths, the immediate goal is to detect and treat early-stage tumors before they pose a threat to life.

Materials and methods

To assess the impact of early detection and intervention in the general population, we analyzed breast cancer incidence and mortality rates in the NCI’s Historical Connecticut Tumor Registry (1943–2002).

Results

Though breast cancer rates increased for the entire study period, overall incidence rates rose faster than previously following the initiation of mammography screening in the early 1980s in the United States. Of note, stage-specific incidence rates increased 152% (53.2–133.9 per 100,000 woman-years) for early-stage tumors and fell 16% (56.1–47.2 per 100,000 woman-years) for late-stage breast cancers. Period- and cohort-age-specific incidence rates rose dramatically for early-stage tumors among women targeted for screening (ages 40–80 years), whereas rates for regional and distant stages declined modestly among women ages >50 years. Breast cancer mortality rates fell 31.6%.

Conclusions

Along with increases in incidence rates for early-stage tumors, rates for late-stage disease and breast cancer mortality declined following widespread screening mammography, consistent with effective early detection and improved treatment over time. However, the disparity between the dramatic rise in early-stage tumors compared to the more modest declines in late-stage disease and mortality suggests that many mammography-derived early-stage lesions may never progress to late-stage cancers and pose a threat to life.

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Author information

Affiliations

  1. Biostatistics Branch, Principal Investigator, DHHS/NIH/NCI/ Division of Cancer Epidemiology and Genetics, EPS, Room 8036, 6120 Executive Blvd., Rockville, MD, 20852-7244, USA

    William F. Anderson

  2. Director of Breast Care Center, Department of Surgery, National Naval Medical Center and Uniformed Services University, Bethesda, MD, USA

    Ismail Jatoi

  3. Biostatistics Branch, Principal Investigator, DHHS/NIH/NCI/ Division of Cancer Epidemiology and Genetics, EPS, Room 8048, 6120 Executive Blvd., Rockville, MD, 20852-7244, USA

    Susan S. Devesa

Authors
  1. William F. Anderson
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  2. Ismail Jatoi
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  3. Susan S. Devesa
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Corresponding author

Correspondence to William F. Anderson.

Additional information

This research was supported in part by the Intramural Research Program of the NIH/National Cancer Institute. The authors would like to thank John Lahey of IMS, Inc. for figure preparation.

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Anderson, W.F., Jatoi, I. & Devesa, S.S. Assessing the impact of screening mammography: breast cancer incidence and mortality rates in Connecticut (1943–2002) . Breast Cancer Res Treat 99, 333–340 (2006). https://doi.org/10.1007/s10549-006-9214-z

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  • DOI: https://doi.org/10.1007/s10549-006-9214-z

Keywords

  • Lead time bias
  • Length bias
  • Prognostic factors
  • Calendar-period effects
  • Birth cohort effects
  • Breast cancer incidence
  • Breast cancer mortality