Evaluation of service mammography screening impact in Italy. The contribution of hazard analysis.
12,987 invasive breast cancer cases were diagnosed in women aged 50-69 upto the year 2001 in nine Italian areas where a screening programme was active. Cases were followed up in 2005 for a total of 1921 breast cancer failures. The 10-year survival rates were 85.3% for the invited group against 75.6% for the non-invited. A time dependent analysis was performed using 5-year intervals. Crude hazard ratios for the invited group in comparison to the not invited group were 0.52 and 0.64 respectively in the (0-5) year and [5-10] year time windows. Hazard ratio adjusted for tumour characteristics was 0.96 in the [5-10] year time window, suggesting minimal or any length bias. Consistent with the results of randomised trials, these analyses of service screening data document a mortality reduction of 36% at 5-10 years after diagnosis.
Paci
Eugenio
E
Clinical and Descriptive Epidemiology Unit, CSPO, Research Institute of the Tuscany Region, Firenze, Italy. e.paci@cspo.it
Coviello
Enzo
E
Miccinesi
Guido
G
Puliti
Donella
D
Cortesi
Laura
L
De Lisi
Vincenzo
V
Ferretti
Stefano
S
Mangone
Lucia
L
Perlangeli
Vincenza
V
Ponti
Antonio
A
Ravaioli
Alessandra
A
de' Bianchi
Priscilla Sassoli
PS
Segnan
Nereo
N
Stracci
Fabrizio
F
Tumino
Rosario
R
Zarcone
Maurizio
M
Zorzi
Manuel
M
Zappa
Marco
M
D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008327:Mammography / Q000401:mortality / Q000592:standards*; D008403:Mass Screening / Q000379:methods / Q000401:mortality; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D016019:Survival Analysis