Format

Send to

Choose Destination
See comment in PubMed Commons below
Eur J Cancer. 2014 Jan;50(1):185-92. doi: 10.1016/j.ejca.2013.08.013. Epub 2013 Sep 13.

Variation in detection of ductal carcinoma in situ during screening mammography: a survey within the International Cancer Screening Network.

Author information

1
Department of Public Health, University of Copenhagen, Copenhagen, Denmark. Electronic address: elsebeth@sund.ku.dk.
2
CPO Piemonte, AOU San Giovanni Battista, Torino, Italy.
3
Department of Surgery, University of Vermont, Burlington, VT, USA.
4
Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
5
Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
6
Mass Screening Registry, Finnish Cancer Registry, Helsinki, Finland.
7
National Cancer Screening Service, Dublin, Ireland.
8
Regional Reference Centre for Breast Cancer Screening, Torino, Italy.
9
Department of Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
10
Programme Mammographie, Direction de la Santé, Luxembourg.
11
National Expert and Training Centre for Breast Cancer Screening, Nijmegen, The Netherlands.
12
The Cancer Registry of Norway, Oslo, Norway.
13
Cancer and Prevention Control Program, Catalan Institute of Oncology, Barcelona, Spain.
14
Breast Cancer Screening Program, Instituto de Salud Pública, Navarra, Spain.
15
General Directorate Research and Public Health and Centre for Public Health Research, Valencia, Spain.
16
Lausanne University Hospital, Epalinges, Switzerland.
17
Department of Medicine and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
18
Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.

Abstract

BACKGROUND:

There is concern about detection of ductal carcinoma in situ (DCIS) in screening mammography. DCIS accounts for a substantial proportion of screen-detected lesions but its effect on breast cancer mortality is debated. The International Cancer Screening Network conducted a comparative analysis to determine variation in DCIS detection.

PATIENTS AND METHODS:

Data were collected during 2004-2008 on number of screening examinations, detected breast cancers, DCIS cases and Globocan 2008 breast cancer incidence rates derived from national or regional cancer registers. We calculated screen-detection rates for breast cancers and DCIS.

RESULTS:

Data were obtained from 15 screening settings in 12 countries; 7,176,050 screening examinations; 29,605 breast cancers and 5324 DCIS cases. The ratio between highest and lowest breast cancer incidence was 2.88 (95% confidence interval (CI) 2.76-3.00); 2.97 (95% CI 2.51-3.51) for detection of breast cancer; and 3.49 (95% CI 2.70-4.51) for detection of DCIS.

CONCLUSIONS:

Considerable international variation was found in DCIS detection. This variation could not be fully explained by variation in incidence nor in breast cancer detection rates. It suggests the potential for wide discrepancies in management of DCIS resulting in overtreatment of indolent DCIS or undertreatment of potentially curable disease. Comprehensive cancer registration is needed to monitor DCIS detection. Efforts to understand discrepancies and standardise management may improve care.

KEYWORDS:

Breast cancer; Cancer registration; Ductal carcinoma in situ (DCIS); Screening mammography

PMID:
24041876
PMCID:
PMC3874251
DOI:
10.1016/j.ejca.2013.08.013
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Support Center