title: Development of breast cancer mortality considering the implementation of mammography screening programs – a comparison of western European countries
creator: Iwamoto, Yukio
creator: Kaucher, Simone
creator: Lorenz, Eva
creator: Bärnighausen, Till
creator: Winkler, Volker
subject: 610
subject: 610 Medical sciences Medicine
description: Background: Triggered by the successive implementation of organized mammography screening programs (MSPs) throughout western European countries over the last decades, there is an ongoing debate questioning their effectiveness. Since it is difficult to assess the effect of MSPs on a population level, we rather aim to assess the impact of the implementation itself on breast cancer mortality rates utilizing an ecological study design.    Methods: We analyzed age group-specific (50–59, 60–69 and 70–79 years) female breast cancer mortality rates in 14 western European countries between 1980 and 2017 using Joinpoint regression, interrupted time series (ITS) regression and multivariable Poisson regression.    Results: The Joinpoint analysis demonstrated decreasing trends resulting in annual percentage changes ranging from − 1.5% to − 5.4% (50–59), − 0.2% to − 8.1% (60–69) and 0% to − 7.1% (70–79) depending on the country within 3 years after MSP implementation. The ITS analysis results in highly significant interaction terms (calendar year * binary MSP indicator) for all age groups. The multivariable regression using “calendar year”, “year of MSP implementation” and “years with MSP” as independent variables yielded a significant yearly decrease for “years with MSP” ranging from 0.9 to 1.2%.    Conclusions: The results of this study suggest a positive association between the implementation of MSPs and the (accelerated) reduction of breast cancer mortality rates. Measuring and quantifying the isolated effect of MSPs on a population level will require additional studies using individual data.
publisher: BioMed Central
date: 2019
type: Article
type: info:eu-repo/semantics/article
type: NonPeerReviewed
format: application/pdf
identifier: https://archiv.ub.uni-heidelberg.de/volltextserverhttps://archiv.ub.uni-heidelberg.de/volltextserver/26705/1/12889_2019_Article_7166.pdf
identifier: DOI:
identifier: urn:nbn:de:bsz:16-heidok-267052
identifier:   Iwamoto, Yukio ; Kaucher, Simone ; Lorenz, Eva ; Bärnighausen, Till ; Winkler, Volker  (2019) Development of breast cancer mortality considering the implementation of mammography screening programs – a comparison of western European countries.  BMC Public Health, 19 (823).  pp. 1-9.  ISSN 1471-2458     
relation: https://archiv.ub.uni-heidelberg.de/volltextserver/26705/
rights: info:eu-repo/semantics/openAccess
rights: Please see front page of the work (Sorry, Dublin Core plugin does not recognise license id)
language: eng