medwireNews: Women who participate in the two most recent screening mammography appointments before a breast cancer diagnosis have a significantly lower risk for death than those who do not attend or only attend one appointment, research shows.
Stephen Duffy (Queen Mary University of London, UK) and co-investigators say “regular participation in screening mammography is necessary to optimize the reduction in risk of dying from breast cancer.”
They add: “Missing even one screening examination confers a significant increase in risk.”
The findings are based on an analysis of data for 549,091 Swedish women (mean age 58.9 years) eligible for screening mammography from 1992 to 2016. During this time, Swedish policy was to screen women aged 40–54 years every 18 months and those aged 55–69 years every 24 months, but screening age ranges varied by county, the researchers note.
Among the women included in the study were 392,135 serial participants who took part in both of their two most recent scheduled screening examinations prior to diagnosis, 41,746 intermittent participants who only attended their most recent screening, 30,945 lapsed participants who only went to the penultimate screening, and 84,265 nonparticipants who did not undergo either examination.
During an average 22 years of observation there were 3995 breast cancer deaths.
The researchers report in Radiology that serial participants had a significant 49% lower risk for breast cancer mortality overall compared with nonparticipants and a significant 50% lower risk for death from breast cancer within 10 years of diagnosis, with similar results observed after adjustment for potential self-selection bias and lead time.
Intermittent and lapsed participants had smaller, but still significant, breast cancer mortality risk reductions of 33% and 28%, respectively, relative to nonparticipants.
When compared with intermittent and lapsed participants, the serial participants had significant 23% and 30% lower risks for breast cancer mortality overall and the investigators note that similar results were observed for breast cancer deaths within 10 years of diagnosis.
By contrast, there was no significant difference in the risk for either outcome between the intermittent and lapsed participants.
Duffy and co-authors conclude that their findings provide “an important message for women in the screening age groups, their referring physicians, and public health decision makers.”
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