eprintid: 26705
rev_number: 12
eprint_status: archive
userid: 1589
dir: disk0/00/02/67/05
datestamp: 2019-08-09 10:43:47
lastmod: 2019-09-03 17:09:26
status_changed: 2019-08-09 10:43:47
type: article
metadata_visibility: show
creators_name: Iwamoto, Yukio
creators_name: Kaucher, Simone
creators_name: Lorenz, Eva
creators_name: Bärnighausen, Till
creators_name: Winkler, Volker
title: Development of breast cancer mortality considering the implementation of mammography screening programs – a comparison of western European countries
subjects: 610
divisions: 912800
keywords: Breast cancer, Mortality, Mammography screening, Europe
abstract: 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.
date: 2019
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1675790086
own_urn: urn:nbn:de:bsz:16-heidok-267052
language: eng
bibsort: IWAMOTOYUKDEVELOPMEN2019
full_text_status: public
publication: BMC Public Health
volume: 19
number: 823
place_of_pub: London
pagerange: 1-9
issn: 1471-2458
citation:   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     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/26705/1/12889_2019_Article_7166.pdf