Mammography use and mode of detection among breast cancer patients in Estonia.
The aim of this study was to examine past mammography use and mode of detection among breast cancer (BC) patients in Estonia, a country that has low screening coverage and high BC mortality. Women newly diagnosed with primary BC in Estonia in 2008-2010 were interviewed. Determinants of past mammography use and the detection of BC by mammography were studied using multivariate logistic regression. Among 977 participants, almost half reported no mammograms prior to the detection of BC. Overall, 22% of the cases were detected by mammography (16% by screening mammography). Detection by mammography was strongly related to age, past mammography use, and obesity. Among cases detected by mammography, 10% were stage III/IV at diagnosis (32% among cases detected by other modes). This study showed low mammography utilization and high rate of self-detection of BC in Estonia. Increased detection by mammography would help diagnose the disease at an earlier stage and consequently avoid premature BC deaths. Efforts should be undertaken to increase participation in screening and improve the availability of mammography among older and high-risk women. The results are likely to be relevant for other countries and population groups with low screening coverage.
a Department of Epidemiology and Biostatistics , National Institute for Health Development , Tallinn , Estonia.
Kaire
K
Innos
b Clinic of Oncology and Haematology , North Estonia Medical Centre , Tallinn , Estonia.|c Competence Center for Cancer Research , Tallinn , Estonia.
Vahur
V
Valvere
d Clinic of Haematology and Oncology , Tartu University Hospital , Tartu , Estonia.|e Clinic of Haematology and Oncology , University of Tartu , Tartu , Estonia.
Peeter
P
Padrik
f Department of Surgical Oncology , Tartu University Hospital , Tartu , Estonia.
Evelyn
E
Eelma
g Clinic of Surgery , North Estonia Medical Centre , Tallinn , Estonia.
Riina
R
Kütner
f Department of Surgical Oncology , Tartu University Hospital , Tartu , Estonia.
Jaak
J
Lehtsaar
a Department of Epidemiology and Biostatistics , National Institute for Health Development , Tallinn , Estonia.
Mare
M
Tekkel
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D036301:Qualitative Research; D012959:Socioeconomic Factors
Breast cancer; detection mode; early detection; mammography; screening; stage