A number of studies have attributed much of the sharp increase in breast cancer incidence in the United States during the 1980s to the increased detection through mammography. The most recent breast cancer data from the US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program show that the incidence trend has slowed, while results from the National Health Interview Survey (NHIS) of 1987 and 1990 indicate that the percentage of women receiving mammograms continues to increase. This phenomenon suggested the need to reassess the relationship between increasingly early detection of breast cancer and overall incidence trends. A polynomial age-cohort model was used to establish the secular trend in incidence rates excluding the impact of recent increases in detection due to the rising use of mammography. Based on the model, the incidence trend in the youngest age group (40 to 49 years) would peak and then begin to decline in the early 1980s. This pattern would manifest itself later in successively older age groups as these younger cohorts age. Breast cancer trends are seen to be generally consistent with the impact of the increased use of mammography when its effect is superimposed upon the background of declining or slowing secular trends. These results support previous reports linking incidence rates with the increase in screening-mammography.
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Hankey BF, Brinton LA, Kessler LG, Abrams J. Breast. In: Miller BA, Ries LAG, Hankey BF, et al, eds. SEER Cancer Statistics Review: 1973–1990. Bethesda, MD (USA): National Cancer Institute, 1993; NIH Pub. No. 92–2789.
Miller BA, Feuer EJ, Hankey BF. The increasing incidence of breast cancer since 1982: relevance of early detection. Cancer Causes Control 1991; 2: 67–74.
White E, Lee CL, Kristal AR. Evaluation of the increase in breast cancer incidence in relation to mammography use. JNCI 1990; 82: 1546–52.
Liff JM, Sung JFC, Chow WH, Greenburg RS, Flanders WD. Does increased detection account for rising incidence of breast cancer? Am J Public Health 1991; 81: 462–5.
Lantz PM, Remington LR, Newcomb PA. Mammography screening and increased incidence of breast cancer in Wisconsin. JNCI 1991; 83: 1450–5.
Feuer EJ, Wun LM. How much of the recent rise in breast cancer incidence can be explained by increase in mammography utilization? Am J Epidemiol 1992; 136: 1423–36.
Breen N, Kessler L. Change in the use of screening mammography: evidence from the 1987 and 1990 National Health Interview Surveys. Am J Public Health 1994; 84: 62–7.
Roush GC, Holford TR, Schymura MJ, White C. Cancer Risk and Incidence Trends: The Connecticut Perspective. New York, NY (USA): Hemisphere Publishing, 1987.
Hahn RA, Moolgavkar SH. Nulliparity, decade of first birth, and breast cancer in Connecticut cohort, 1855 to 1945: an ecological study. Am J Public Health 1989; 79: 1503–7.
Holford TR, Roush GC, McKay LA. Trends in female breast cancer in Connecticut and the United States. J Clin Epidemiol 1991; 44: 29–39.
Miller BA, Ries LAG, Hankey BF, et al. Overview. In: Miller BA, Ries LAG, Hankey BF, et al, eds. SEER Cancer Statistics Review: 1973–1990. Bethesda, MD (USA): National Cancer Institute, 1993; NIH Pub. No. 93–2789.
Baker LH. Breast cancer detection demonstration project: five year summary report. CA Cancer J Clin 1982; 32: 194–225.
Numerical Algorithms Group, Ltd. The Generalized Linear Interactive Modeling (GLIM) System Release 3.77. Oxford, UK: Royal Statistical Society, 1985.
Seidman H, Gelb SK, Silverberg E, La Verda N, Lubera JA. Survival experience in the Breast Cancer Detection Demonstration Project. CA Cancer J Clin 1987; 37: 258–90.
Gail MH, Brinton LA, Byar DP, et al. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. JNCI 1989; 81: 1879–86.
van Oortmarssen GJ, Habbema JDF, van der Maas PJ. A model for breast cancer screening. Cancer 1990; 66: 1601–12.
Fox SH, Moskowitz M, Saenger EL, Kerelakes JG, Milbrath J, Goodman MW. Benefit/Risk analysis of aggressive mammographic screening. Radiology 1978; 128: 359–65.
Day NE, Walter SD, Tabar L, Fagerberg CJG, Collette HJA. The sensitivity and lead time of breast cancer screening: a comparison of the result of different studies. In: Day NE, Miller AB, eds. Screening for Cancer. Toronto, Ontario (Canada): H Huber, 1988: 105–9.
Paci E, Ciatto S, Buiatti E, Cecchini S, Palli D, Turco MRD. Early indicators of efficacy of breast cancer screening programmes: results of the Florence District Programme. Int J Cancer 1990; 46: 198–202.
Day NE, Walter SD. Simplified models of screening for chronic disease: estimation procedures from mass screening programmes. Biometrics 1984; 40: 1–14.
Howard J. Using mammography for cancer control: an unrealized potential. Ca Cancer J Clin 1987; 37: 33–48.
King ES, Rimer BK, Trock B, Balshem A, Engstorm PF. How valid are mammography self-reports? Am J Public Health 1990; 80: 1386–8.
Degnan D, Norris R, Ranney J, Quade D, Earp JA, Gonzalez JJ. Measuring the use of mammography: two methods compared. Am J Public Health 1992; 82: 1386–8.
Fulton-Kehoe D, Burg MA, Lane DS. Are self-reported dates of mammograms accurate? Public Health Rev 1993; 20: 233–40.
Etzi S, Lane DS, Grimson R. The use of mammography vans by low-income women: the accuracy of self-reports. Am J Public Health 1994; 84: 107–9.
Breen N, Kessler L. Current trends in cancer screening: 1987 and 1992 NHIS. Am J Public Health 1994; 84: 62–7.
Houn F, Brown M. Current practice of screening mammography in the United States: data from the National Survey of Mammography facilities. Radiology 1994; 190: 209–15.
Chang P. A simulation study of breast cancer epidemiology and detection since 1982: the case for limited malignant potential lesions. PhD dissertation, University of Wisconsin-Madison (USA), 1993.
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Wun, LM., Feuer, E.J. & Miller, B.A. Are increases in mammographic screening still a valid explanation for trends in breast cancer incidence in the United States?. Cancer Causes Control 6, 135–144 (1995). https://doi.org/10.1007/BF00052774
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DOI: https://doi.org/10.1007/BF00052774