Breast Cancer Screening - Mammography

Br J Cancer. 2008 Jan 15;98(1):206-9.
A case-control study of the impact of the East Anglian breast screening programme on breast cancer mortality.
Allgood PC, Warwick J, Warren RM, Day NE, Duffy SW.

Cancer Research UK Department of Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK. prue. Allgood@cancer.org.uk

Although breast cancer screening has been shown to work in randomised trials, there is a need to evaluate service screening programmes to ensure that they are delivering the benefit indicated by the trials. We carried out a case-control study to investigate the effect of mammography service screening, in the NHS breast screening programme, on breast cancer mortality in the East Anglian region of the UK. Cases were deaths from breast cancer in women diagnosed between the ages of 50 and 70 years, following the instigation of the East Anglia Breast Screening Programme in 1989. The controls were women (two per case) who had not died of breast cancer, from the same area, matched by date of birth to the cases. Each control was known to be alive at the time of death of her matched case. All women were known to the breast screening programme and were invited, at least once, to be screened. There were 284 cases and 568 controls. The odds ratio (OR) for risk of death from breast cancer in women who attended at least one routine screen compared to those who did not attend was 0.35 (CI: 0.24, 0.50). Adjusting for self-selection bias gave an estimate of the breast cancer mortality reduction associated with invitation to screening of 35% (OR=0.65, 95% CI: 0.48, 0.88). The effect of actually being screened was a 48% breast cancer mortality reduction (OR=0.52, 95% CI: 0.32, 0.84). The results suggest that the National Breast Screening Programme in East Anglia is achieving a reduction in breast cancer deaths, which is at least consistent with the results from the randomised controlled trials of mammographic screening.

Q32. 1 What is cancer (malignancy)
Q32. 2 What is meant by cancer staging?
Q32. 3 How prevalent is cancer?
Q32. 4 How prevalent are womens' cancers?
Q32. 5 What causes cancer?
Q32. 6 Is cancer a hereditary condition?
Q32. 7 How can gynaecological cancer present?
Q32. 8 How can we reduce the risks of the womens' cancers?

Reducing the Risks of Womens' Cancers.

Q32. 9 What are screening tests?
Q32. 10 What are the reactions to a diagnosis of cancer?
Q32. 11 Is there a place for counselling when cancer is diagnosed?
Q32. 12 Can personality alter the prognosis?
Q32. 13 Is the incidence of deaths from the female cancers changing?
Q32. 14 Is there a place for a holistic approach to cancer?

Cancer of the Cervix.

Q32. 15 How prevalent is cervical cancer?
Q32. 16 What causes cervical cancer?
Q32. 17 How long an interval should there be between cervical screening (smear) (PAP) tests?
Q32. 18 Is there any evidence that cervical screening can reduce the incidence of cervical cancer?
Q32. 19 Will pre-malignant changes of the cervix invariably lead to cancer?

Endometrial Cancer (Uterus)

Q32. 20 What causes endometrial cancer?
Q32. 21 Are there screening tests for endometrial cancer?
Q32. 22 How does endometrial cancer present?

Cancer of the Ovary.

Q32. 23 How does ovarian cancer present?
Q32. 24 How prevalent is ovarian cancer?
Q32. 25 What are tumour markers?
Q32. 26 Can we screen for ovarian cancer?
Q32. 27 What is the relationship between infertility and ovarian cancer?
Q32. 28 Can treatment of infertility increase the risk of ovarian cancer?
Q32. 29 What is the relationship between oral contraception and cancer?
Q32. 30 Can ovarian cancer be prevented?
Q32. 31 I use talcum power. Could this increase my risk of developing ovarian cancer?

The Treatment Of Womens' Cancers

Q32. 32 Can we predict the course of a cancer?
Q32. 33 What treatment options are available for gynaecological cancer?
Q32.33c What treatment options are available for ovarian cancer?

Cancer of the Vulva, Vagina and Fallopian Tube

Q32. 34 How prevalent are malignant conditions of the vulva, vagina and Fallopian tubes?
Breast Cancer

Q32. 35a What are the advantages of breast cancer screening - mammography - mammograms?
Q32. 36 How often should breast screening be carried out?
Q32. 37 Are there any problems having a mammogram?
Q32. 38 Should I check myself for breast lumps?
Q32. 39 One of my family developed cancer of the breast. Am I at increased risk?
Q32. 40 We have a family tendency towards developing breast / ovarian cancer. Are there any genetic tests to find out if I am at increased risk?
Q32. 41 What happens if a mammogram shows an abnormality?
Q32. 42 What are the advantages and disadvantages of tamoxifen in the management of breast cancer?
Q32. 42a Breast Cancer Treatment - What is available?
Q32. 43 What is the relationship between breast cancer and the pill?
Web sites and Support Groups

Q32. 44 Are there any support groups?
Q32. 44 Are there any support groups?
Q32. 45 Support Groups.
Q32. 46 Breast Cancer Support Groups
Q32. 47 Ovarian Cancer Support Groups
Q32. 48 Endometrial Cancer Support Groups
Q32. 49 Cervical Cancer Support Groups

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