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. 2000 Sep 16;321(7262):665-9.
doi: 10.1136/bmj.321.7262.665.

Effect of NHS breast screening programme on mortality from breast cancer in England and Wales, 1990-8: comparison of observed with predicted mortality

R G Blanks  1 , S M Moss, C E McGahan, M J Quinn, P J Babb
Affiliations

Effect of NHS breast screening programme on mortality from breast cancer in England and Wales, 1990-8: comparison of observed with predicted mortality

R G Blanks et al. BMJ. .

Abstract

Objective: To assess the impact of the NHS breast screening programme on mortality from breast cancer in women aged 55-69 years over the period 1990-8.

Design: Age cohort model with data for 1971-89 used to predict mortality for 1990-8 with assumption of no major effect from screening or improvements in treatment until after 1989. Effect of screening and other factors on mortality estimated by comparing three year moving averages of observed mortality with those predicted (by five year age groups from 50-54 to 75-79), the effect of screening being restricted to certain age groups.

Setting: England and Wales.

Subjects: Women aged 40 to 79 years.

Results: Compared with predicted mortality in the absence of screening or other effects the total reduction in mortality from breast cancer in 1998 in women aged 55-69 was estimated as 21.3%. Direct effect of screening was estimated as 6.4% (range of estimates from 5.4-11.8%). Effect of all other factors (improved treatment with tamoxifen and chemotherapy, and earlier presentation outside the screening programme) was estimated as 14.9% (range 12.2-14.9%).

Conclusions: By 1998 both screening and other factors, including improvements in treatment, had resulted in substantial reductions in mortality from breast cancer. Many deaths in the 1990s will be of women diagnosed in the 1980s and early 1990s, before invitation to screening. Further major effects from screening and treatment are expected, which together with cohort effects should result in further substantial reductions in mortality from breast cancer, particularly for women aged 55-69, over the next 10 years.

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Figures

Figure 1
Figure 1
Mortality from breast cancer by year of death for selected age groups, England and Wales, 1971-99
Figure 2
Figure 2
Mortality from breast cancer by year of birth for selected age groups, England and Wales, 1971-99
See this image and copyright information in PMC

Comment in

References

    1. Forrest APM. Breast cancer screening: report to the health ministers of England, Wales, Scotland and Northern Ireland. London: HMSO; 1986.
    1. Department of Health. The health of the nation: a strategy for health in England. London: HMSO; 1992.
    1. Coleman MP, Babb P, Damiecki P, Groscalude P, Honjo S, Jones J, et al. Cancer survival trends in England and Wales 1971-1995: deprivation and NHS region. London: Stationery Office; 1999. . (Studies in medical population subjects No 61.)
    1. Moss S, Blanks R.for the Interval Cancer Working Group. Calculating appropriate target cancer detection rates and expected interval cancer rates for the UK NHS breast screening programme J Epidemiol Community Health 199852111–115. - PMC - PubMed
    1. Tabar L, Fagerberg CJ, Gad A, Baldetorp L, Holmberg LH, Grontoft O, et al. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the breast cancer screening working group of the Swedish National Board of Health and Welfare. Lancet. 1985;i:829–832. - PubMed

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