Effect of mammography screening on the long-term survival of breast cancer patients: results from the National Cancer Screening Program in Korea
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OBJECTIVES: This study investigated the effect of mammography screening on the long-term survival of breast cancer (BC) patients aged 40 years or older according to their screening history and duration since screening. METHODS: The study cohort was organized from 3 nationwide databases of the Korean National Cancer Screening Program, the Korean Central Cancer Registry, and death certificates. We included 24,387 women diagnosed with invasive BC or ductal carcinoma in situ in 2008 and 2009 and followed up until December 31, 2019. Cox proportional-hazards regression was used to investigate the effect of BC screening on the risk of death. RESULTS: Overall, 20,916 of 24,387 patients (85.8%) were alive at the end of the follow-up period (median: 10.5 years). The long-term survival rate was significantly lower in the never-screened group (80.3%) than in the screened group (88.9%) (p< 0.001). A 35% reduction in the risk of BC death (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.60 to 0.70) from screening was observed. A subgroup analysis according to the cancer stage showed 62%, 36%, and 24% lower risks of BC death for the localized stage, regional stage, and distant stage, respectively. Women aged 40-49 years received the least benefit from BC screening (HR, 0.71; 95% CI, 0.62 to 0.81). CONCLUSIONS: Mammography screening was effective in reducing the risk of BC-specific death in Asian women across all cancer stages. However, this effect was relatively small among women in their 40s, suggesting that more detailed and specialized screening strategies are needed for that age group.
Abstract
OBJECTIVES: This study investigated the effect of mammography screening on the long-term survival of breast cancer (BC) patients aged 40 years or older according to their screening history and duration since screening. METHODS: The study cohort was organized from 3 nationwide databases of the Korean National Cancer Screening Program, the Korean Central Cancer Registry, and death certificates. We included 24,387 women diagnosed with invasive BC or ductal carcinoma in situ in 2008 and 2009 and followed up until December 31, 2019. Cox proportional-hazards regression was used to investigate the effect of BC screening on the risk of death. RESULTS: Overall, 20,916 of 24,387 patients (85.8%) were alive at the end of the follow-up period (median: 10.5 years). The long-term survival rate was significantly lower in the never-screened group (80.3%) than in the screened group (88.9%) (p< 0.001). A 35% reduction in the risk of BC death (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.60 to 0.70) from screening was observed. A subgroup analysis according to the cancer stage showed 62%, 36%, and 24% lower risks of BC death for the localized stage, regional stage, and distant stage, respectively. Women aged 40-49 years received the least benefit from BC screening (HR, 0.71; 95% CI, 0.62 to 0.81). CONCLUSIONS: Mammography screening was effective in reducing the risk of BC-specific death in Asian women across all cancer stages. However, this effect was relatively small among women in their 40s, suggesting that more detailed and specialized screening strategies are needed for that age group.
참고문헌 (32)
- Sung H, "Global cancer statistics 2020 : GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185countries", CA Cancer J Clin, 71, pp.209~249 (2021)
- OECD, "Health at a Glance 2017: OECD Indicators" (2017), OECD Publishing
- Bhoo-Pathy N, "Breast cancer research in Asia: adopt or adapt Western knowledge?", Eur J Cancer, 49, pp.703~709 (2013)
- Green M, "Epidemiology, screening and diagnosis of breast cancer in the Asia–Pacific region: current perspectives and important considerations", Asia Pac J Clin Oncol, 4(Suppl 3), pp.S5~S13 (2008)
- Lauby-Secretan B, "Breast-cancer screening--viewpoint of the IARC Working Group", N Engl J Med, 372, pp.2353~2358 (2015)
- Maskarinec G, "Ethnic differences in mammographic densities", Int J Epidemiol, 30, pp.959~965 (2001)
- Choi KS, "Effect of mammography screening on stage at breast cancer diagnosis : results from the Korea National Cancer Screening Program", Sci Rep, 8, pp.8882~ (2018)
- Huang Y, "Preliminary effectiveness of breast cancer screening among 1. 22 million Chinese females and different cancer patterns between urban and rural women", Sci Rep, 6, pp.39459~ (2016)
- Yen AM, "Population-based breast cancer screening with risk-based and universal mammography screening compared with clinical breast examination : a propensity score analysis of 1 429 890 Taiwanese women", JAMA Oncol, 2, pp.915~921 (2016)
- 홍세리, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2018", Cancer Research and Treatment, 53(2), pp.301~315 (2021), 대한암학회[DOI]
- 홍세리, "Trends in Cancer Screening Rates among Korean Men and Women: Results of the Korean National Cancer Screening Survey, 2004–2018", Cancer Research and Treatment, 53(2), pp.330~338 (2021), 대한암학회[DOI]
- Choi E, "Effectiveness of the Korean National Cancer Screening Program in reducing breast cancer mortality", NPJ Breast Cancer, 7, pp.83~ (2021)
- "ICD-10: international statistical classification of diseases and related health problems: tenth revision, 2nd ed" (2004)[URL]
- "International classification of diseases for oncology (ICD-O), 3rd ed., 1st revision" (2013)[URL]
- Li CI, "Risk of mortality by histologic type of breast cancer among women aged 50 to 79 years", Arch Intern Med, 163, pp.2149~2153 (2003)
- "SEER summary staging manual - 2000: codes and coding instructions" (2001)[URL]
- Mizoue T, "Prospective study of screening for stomach cancer in Japan", Int J Cancer, 106, pp.103~107 (2003)
- Lehtimäki T, "Long-term prognosis of breast cancer detected by mammography screening or other methods", Breast Cancer Res, 13, pp.R134~ (2011)
- Duffy SW, "Mammography screening reduces rates of advanced and fatal breast cancers : results in 549, 091 women", Cancer, 126, pp.2971~2979 (2020)
- Kaplan HG, "Effect of treatment and mammography detection on breast cancer survival over time : 1990-2007", Cancer, 121, pp.2553~2561 (2015)
- Kalager M, "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 Res, 11, pp.R44~ (2009)
- Bordás P, "Survival from invasive breast cancer among interval cases in the mammography screening programmes of northern Sweden", Breast, 16, pp.47~54 (2007)
- Klemi PJ, "Significant improvement in breast cancer survival through population-based mammography screening", Breast, 12, pp.308~313 (2003)
- Tabár L, "The natural history of breast carcinoma : what have we learned from screening", Cancer, 86, pp.449~462 (1999)
- Joensuu H, "Risk for distant recurrence of breast cancer detected by mammography screening or other methods", JAMA, 292, pp.1064~1073 (2004)
- Bae JM, "Distribution of dense breasts using screening mammography in Korean women : a retrospective observational study", Epidemiol Health, 36, pp.e2014027~ (2014)
- Siu AL, "Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement", Ann Intern Med, 164, pp.279~296 (2016)
- Oeffinger KC, "Breast cancer screening for women at average risk : 2015 guideline update from the American Cancer Society", JAMA, 314, pp.1599~1614 (2015)
- Monticciolo DL, "Breast cancer screening for average-risk women : recommendations from the ACR commission on breast imaging", J Am Coll Radiol, 14, pp.1137~1143 (2017)
- Helvie MA, "Perspectives on the overdiagnosis of breast cancer associated with mammographic screening", J Breast Imaging, 1, pp.278~282 (2019)
- van Seijen M, "Ductal carcinoma in situ : to treat or not to treat, that is the question", Br J Cancer, 121, pp.285~292 (2019)
- Narod SA, "Breast cancer mortality after a diagnosis of ductal carcinoma in situ", JAMA Oncol, 1, pp.888~896 (2015)