A case-control study to evaluate the impact of the breast screening programme on mortality in England
Menée en Angleterre à partir de données portant sur 8 288 patientes décédées en 2010 ou 2011 d'un cancer primitif du sein et à partir de données portant sur 15 202 témoins, cette étude évalue l'effet du programme national de dépistage du cancer du sein par mammographie sur la mortalité
Background : Over the past 30 years since the implementation of the National Health Service Breast Screening Programme, improvements in diagnostic techniques and treatments have led to the need for an up-to-date evaluation of its benefit on risk of death from breast cancer. An initial pilot case-control study in London indicated that attending mammography screening led to a mortality reduction of 39%.
Methods : Based on the same study protocol, an England-wide study was set up. Women aged 47–89 years who died of primary breast cancer in 2010 or 2011 were selected as cases (8288 cases). When possible, two controls were selected per case (15,202 controls) and were matched by date of birth and screening area.
Results : Conditional logistic regressions showed a 38% reduction in breast cancer mortality after correcting for self-selection bias (OR 0.62, 95% CI 0.56–0.69) for women being screened at least once. Secondary analyses by age group, and time between last screen and breast cancer diagnosis were also performed.
Conclusions : According to this England-wide case-control study, mammography screening still plays an important role in lowering the risk of dying from breast cancer. Women aged 65 or over see a stronger and longer lasting benefit of screening compared to younger women.
British Journal of Cancer , article en libre accès, 2020