Breast cancer incidence and mortality in Tyrol/Austria after fifteen years of opportunistic mammography screening
- Equal contributors
1 Department of Clinical Epidemiology of the Tyrolean State Hospitals Ltd, Cancer Registry of Tyrol, Innsbruck, Austria
2 Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Information Systems and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall iT, Austria
3 Oncotyrol - Center for Personalized Cancer Medicine, Innsbruck Medical University, Innsbruck, Austria
4 University Hospital, Innsbruck, Austria
5 Innsbruck Medical University, Department of Radiology, Innsbruck, Austria
6 Kufstein County Hospital, Department of Radiology, Kufstein, Austria
7 Innsbruck Medical University, Department of Obstetrics and Gynecology, Innsbruck, Austria
8 Program in Health Decision Science, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA
9 Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
BMC Public Health 2010, 10:86 doi:10.1186/1471-2458-10-86Published: 20 February 2010
The aim of this study was to analyse breast cancer incidence and mortality in Tyrol from 1970 to 2006, namely after performing more than a decade of opportunistic mammography screening and just before piloting an organised screening programme. Our investigation was conducted on a population level.
To study time trends in breast cancer incidence and mortality, we applied the age-period-cohort model by Poisson regression to the official mortality data covering more than three decades from 1970 to 2006 and to the incidence data ranging from 1988 to 2006. In addition, for incidence data we analysed data on breast cancer staging and compared these with EU guidelines.
For the analysis of time trend in breast cancer mortality in age groups 40-79, an age-period-cohort model fits well and shows for years 2002-2006 a statistically significant reduction of 26% (95% CI 13%-36%) in breast cancer mortality as compared to 1992-1996.
We see only slight non-significant increases in breast cancer incidence. For the past five years, incidence data show a 10% proportion of in situ cases, and of 50% for cases in stages II+.
The opportunistic breast cancer screening programme in Tyrol has only in part exploited the mortality reduction known for organised screening programmes. There seems to be potential for further improvement, and we recommend that an organised screening programme and a detailed screening database be introduced to collect all information needed to analyse the quality indicators suggested by the EU guidelines.