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Evaluation of breast cancer incidence: is the increase due entirely to mammographic screening?

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Abstract

Objectives: To examine the trends in the incidence rates of breast cancer in a population with mammographic screening and in the unscreened women within that population.

Methods: Data consisted of incident cases of breast cancer notified to the Victorian Cancer Registry in Victoria, Australia, between 1988 and 1996 and cases detected in the population-based BreastScreen Program. These data were grouped by age (25–39, 40–49, 50–59, 60–69 and ≥70 years of age) and size of tumor (≤10 mm, > 10–≤15 mm, and > 15mm). Poisson regression modeling was used to examine trends by age, tumor size, calendar year and availability of screening.

Results: The incidence rate of breast cancer in the total population increased between 1988 and 1996. The greatest increase was seen after 1993 when population-based screening became available. In unscreened women, modeling demonstrated a statistically significant (p < 0.01) 1.5% annual increase in the incidence rate. The annual increase in this rate differed by size of tumor and was approximately 8% (p < 0.01) for small tumors (≤ 10 mm) but not significant for tumors > 10 mm. The greatest increase was in small tumors for women ≥ 50 years of age.

Conclusion: The incidence of breast cancer has increased since population-based mammographic screening was introduced in 1994. The rate in unscreened women also showed a significant increase. This was greatest in small tumors for women ≥ 50 years of age. Whether this will translate into an increase in mortality is uncertain and long-term monitoring is required to determine if cohort and period effects impact on the underlying incidence of breast cancer in Victoria.

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Authors and Affiliations

  1. Department of Human Services of Victoria, Public Health & Development Branch, 120 Spencer St, Melbourne, Victoria, 3000, Australia

    Catherine Harmer

  2. Cancer Epidemiology Centre, Anti-Cancer Council of Victoria, 1 Rathdowne Street, Carlton South, Victoria, 3053, Australia

    Margaret Staples & Anne M. Kavanagh

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  1. Catherine Harmer
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  2. Margaret Staples
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  3. Anne M. Kavanagh
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Harmer, C., Staples, M. & Kavanagh, A.M. Evaluation of breast cancer incidence: is the increase due entirely to mammographic screening?. Cancer Causes Control 10, 333–337 (1999). https://doi.org/10.1023/A:1008949819969

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