Influence of mammographic screening on breast cancer incidence trends in South Australia

Kerri Rose Beckmann, David Murray Roder, Janet Esther Hiller, Gelareh Farshid, William John Lynch

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

PURPOSE: To examine breast cancer (BC) incidence trends in relation to mammographic screening and risk factor prevalence in South Australia (SA).

MATERIALS AND METHODS: Trends in annual BC incidence rates were calculated using direct standardisation and compared with projected incidence derived from Poisson regression analysis of pre-screening rates. Annual percentage change and change time points were estimated using Joinpoint software. Biennial mammography screening participation rates were calculated using data from BreastScreen SA. Trends in overweight/obesity, alcohol use and hormone replacement therapy (HRT) use were examined using 1991-2009 Health Omnibus Survey data. Trends in total fertility were examined using data from the Australian Bureau of Statistics.

RESULTS: BC incidence increased around the time BreastScreen commenced and then stabilised in the mid-1990s. However rates have remained higher than projected, even though the proportion and age distribution of first time screening attendees stabilised around 1998. A decrease in BC incidence was observed among women aged 50-59yrs from the late-1990's but not among older women. Obesity and alcohol use have increased steadily in all age groups, while HRT use declined sharply from the late-1990s.

CONCLUSIONS: BC incidence has remained higher than projected since mammography screening began. The sustained elevation is likely to be due to lead time effects, though over-diagnosis cannot be excluded. Declining HRT use has also impacted incidence trends.

IMPLICATIONS: Studies using individual level data, which can account for changes in risk factor prevalence and lead time effects, are required to evaluate 'over-diagnosis' due to screening.

Original languageEnglish
Pages (from-to)3105-3112
Number of pages8
JournalAsian Pacific Journal of Cancer Prevention
Volume15
Issue number7
DOIs
Publication statusPublished - 1 Jan 2014
Externally publishedYes

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking
  • Australia
  • Breast Neoplasms
  • Early Detection of Cancer
  • Female
  • Hormone Replacement Therapy
  • Humans
  • Mammography
  • Middle Aged
  • Obesity
  • Risk Factors
  • Journal Article
  • Research Support, Non-U.S. Gov't
  • Mammographic screening
  • Breast cancer
  • Incidence trends

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