Decreasing breast cancer death rates not due to Screening, more to do with treatments and health care systems

3.67 (3 votes)
Breast cancer mortality rates in Europe in the past few years have fallen, however, researchers from France, Norway and the United Kingdom say that this is due to better treatment and health systems instead of screening for breast cancer. In an article In the BMJ (British Medical Journal), the authors wrote that "...screening for breast cancer has not played a direct role in reducing breast cancer mortality in recent years. "

In the most developed countries has spent the last few years breast cancer mortality to fall. The authors say that it is very difficult to determine what share of that reduction of more than two decades of mammography screening is due to early detection and better management.

Cervical cancer is concerned, it is clearer evidence that screening programs have led to lower mortality rates. From 1965 to 1980 Nordic countries implemented screening programs for their European neighbours, and previously experienced falls in mortality rate for cervical cancer.

In this study, the researchers decided a similar approach. They compared breast cancer mortality trends within three pairs of countries: Northern Ireland vs. Republic of IrelandThe Netherlands VS Belgium (Flanders) Sweden vs. NorwayAll the researchers had expected to death shipping cost dropping earlier in countries that implemented breast cancer screening programs first. The pairs of countries had similar peoples, similar breast cancer risk factors, and almost the same level of health care. The only real difference was that in each pair, one country started mammography much later than the other.

The authors collected data from the WHO (World Health Organization) mortality database on the causes of death from 1980 to 2006. They also collected information on risk factors, death, mammography screening and treatment of cancer.

Between 1989 and 2006, decreased mortality of breast cancer with the following rates in the three pairs of countries: 29% in Northern Ireland, compared with 26% in the Republic of Ireland25% in Netherlands, in comparison with 20% in Belgium (25% in Flanders) 16% in Sweden compared with 23% in NorwayThe mortality in the pairs of countries were not that differentmammography, although performances were performed many years apart, the authors explained. The researchers also pointed out that the largest reductions were among women from 40 to 49 years, whether or not they had screening available seemed to make no difference.

The authors concluded:

"The contrast between the time differences in implementation of mammography screening and the similarity in reduction of mortality between the couples country suggest that screening does not play a direct role in the reduction in breast cancer mortality.

Improvements in the treatment and the efficiency of healthcare systems efficiency may be more plausible explanation. "

Written by Christian Nordqvist
Copyright: Medical News today
Not to be reproduced without the permission of medical news today

Article reference:
"Breast cancer mortality in neighbouring European countries with different levels of screening but comparable access to treatment: trend analysis of WHO mortality database"
Philippe Autier, Mathieu Boniol, Anna Gavin, Lars J Vatten
BMJ 2011; 343: d4411 doi: 10.1136/d4411 bmj.