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. 2021 Jun 28;7(1):83.
doi: 10.1038/s41523-021-00295-9.

Effectiveness of the Korean National Cancer Screening Program in reducing breast cancer mortality

Eunji Choi  1 , Jae Kwan Jun  2 , Mina Suh  2 , Kyu-Won Jung  2 , Boyoung Park  3 , Kyeongmin Lee  1 , So-Youn Jung  4 , Eun Sook Lee  4 , Kui Son Choi  5
Affiliations

Effectiveness of the Korean National Cancer Screening Program in reducing breast cancer mortality

Eunji Choi et al. NPJ Breast Cancer. .

Abstract

High incidences of breast cancer (BC) are reported in Asian women in their forties, and it is not clear whether mammographic screening reduces mortality among them. This study evaluated the effect of BC screening on mortality in Korea. We conducted a nationwide prospective cohort study of women invited to the Korean National Cancer Screening Program (KNCSP) between 2002 and 2003 (N = 8,300,682), with data linkage to the Korea Central Cancer Registry and death certificates through 2014 and 2015, respectively. Exposure to mammographic screening was defined using a modified never/ever approach. The primary study outcome was adjusted mortality rate ratio (MRR) for BC among screened and non-screened women estimated by Poisson regression. An adjusted MRR for all cause-death other than BC was examined to account for selection bias in the cohort. BC incidence rates for screened and non-screened women were 84.41 and 82.88 per 100,000 women-years, respectively. BC mortality rates for screened and non-screened women were 5.81 and 13.43 per 100,000 women-years, respectively, with an adjusted MRR for BC of 0.43 (95% CI, 0.41-0.44). The adjusted MRR for all-cause death excluding BC was 0.52 (95% CI, 0.52-0.52). The greatest reduction in BC mortality was noted for women aged 45-54 years, and there was no observable reduction in mortality after the age of 70 years. In conclusion, the KNCSP has been effective in reducing BC mortality among Korean women aged 40-69 years.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Flow diagram for the study-cohort in the Korean National Cancer Screening Program.
Exposure to breast cancer screening was defined using a modified never/ever approach by which women were considered ever screened after theirfirst screening attendance (see "Methods").
Fig. 2
Fig. 2. Cumulative mortality rates between the screened and non-screened cohorts in the KNCSP, 2002−2015.
a Cumulative mortality rates with 95% confidence intervals. b Nelson−Aalen estimates of the cumulative mortality rates with 95% confidence intervals.
See this image and copyright information in PMC

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