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14 years of follow-up from the Edinburgh randomised trial of breast-cancer screening.

https://arctichealth.org/en/permalink/ahliterature20979
Source
Lancet. 1999 Jun 5;353(9168):1903-8
Publication Type
Article
Date
Jun-5-1999
Author
F E Alexander
T J Anderson
H K Brown
A P Forrest
W. Hepburn
A E Kirkpatrick
B B Muir
R J Prescott
A. Smith
Author Affiliation
Department of Community Health Sciences, University of Edinburgh, UK. freda.alexander@ed.ac.uk
Source
Lancet. 1999 Jun 5;353(9168):1903-8
Date
Jun-5-1999
Language
English
Publication Type
Article
Keywords
Age Factors
Breast Neoplasms - mortality - prevention & control - radiography
Cohort Studies
Female
Follow-Up Studies
Health Services Research
Humans
Logistic Models
Mammography - utilization
Mass Screening - utilization
Middle Aged
Research Support, Non-U.S. Gov't
Scotland - epidemiology
Survival Rate
Time Factors
Abstract
BACKGROUND: The Edinburgh randomised trial of breast-cancer screening recruited women aged 45-64 years from 1978 to 1981 (cohort 1), and those aged 45-49 years during 1982-85 (cohorts 2 and 3). Results based on 14 years of follow-up and 270,000 woman-years of observation are reported. METHODS: Breast-cancer mortality rates in the intervention group (28,628 women offered screening) were compared with those in the control group (26,026) with adjustment for socioeconomic status (SES) of general medical practices. Rate ratios were derived by means of logistic regression for the total trial population and for women first offered screening while younger than 50 years. Analyses were by intention to treat. FINDINGS: Initial unadjusted results showed a difference of just 13% in breast-cancer mortality rates between the intervention and control groups (156 deaths [5.18 per 10,000] vs 167 [6.04 per 10,000]; rate ratio 0.87 [95% CI 0.70-1.06]), but the results were influenced by differences in SES by trial group. After adjustment for SES, the rate ratio was 0.79 (95% CI 0.60-1.02). When deaths after diagnosis more than 3 years after the end of the study were censored the rate ratio became 0.71 (0.53-0.95). There was no evidence of heterogeneity by age at entry and no evidence that younger entrants had smaller or delayed benefit (rate ratio 0.70 [0.41-1.20]). No breast-cancer mortality benefit was observed for women whose breast cancers were diagnosed when they were younger than 50 years. Other-cause mortality rates did not differ by trial group when adjusted for SES. INTERPRETATION: Our findings confirm results from randomised trials in Sweden and the USA that screening for breast cancer lowers breast-cancer mortality. Similar results are reported by the UK geographical comparison, UK Trial of Early Detection of Breast Cancer. The results for younger women suggest benefit from introduction of screening before 50 years of age.
Notes
Comment In: Lancet. 1999 Jun 5;353(9168):1896-710371561
Comment In: Lancet. 1999 Sep 11;354(9182):946-710489974
Comment In: Lancet. 1999 Sep 11;354(9182):946; author reply 94710489973
Comment In: Lancet. 1999 Sep 11;354(9182):947-810489975
Comment In: Lancet. 2001 Dec 22-29;358(9299):2165; author reply 2167-811784654
PubMed ID
10371567 View in PubMed
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Acid haze air pollution and breast and colon cancer mortality in 20 Canadian cities.

https://arctichealth.org/en/permalink/ahliterature231165
Source
Can J Public Health. 1989 Mar-Apr;80(2):96-100
Publication Type
Article
Author
E D Gorham
C F Garland
F C Garland
Source
Can J Public Health. 1989 Mar-Apr;80(2):96-100
Language
English
Publication Type
Article
Keywords
Aerosols
Air Pollutants - toxicity
Breast Neoplasms - mortality
Canada
Colonic Neoplasms - mortality
Female
Humans
Male
Sulfates - toxicity
Sulfur Dioxide - toxicity
Abstract
Sulfur dioxide absorbs ultraviolet light in the region of the spectrum which is most active in forming vitamin D on the skin. Sulfate particles reflect light at this wavelength. High concentrations of these pollutants (acid haze) may lead to vitamin D deficiencies in exposed populations. Epidemiologic and laboratory evidence suggests that vitamin D plays a role in reducing risk of colon and breast cancer. We examined the association between sulfur dioxide and ultraviolet-light-blocking aerosols in 20 Canadian cities, and age-adjusted breast and colon cancer mortality rates in the census divisions encompassing these cities. Statistically significant positive associations were found between these two measures of air pollution and age-adjusted mortality rates for colon cancer in women (multiple r = +.74, p = 0.003), and men (multiple r = +.61, p = 0.03), and breast cancer in women (multiple r = +.69, p = 0.007). Mortality rates for all other reported cancer sites were also examined, and no statistically significant positive associations were found consistently in both sexes. The ecological nature of this study is emphasized, and the possibility that an indirect association could explain these findings is discussed.
PubMed ID
2720547 View in PubMed
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Adjusting Expected Mortality Rates Using Information From a Control Population: An Example Using Socioeconomic Status.

https://arctichealth.org/en/permalink/ahliterature300404
Source
Am J Epidemiol. 2018 04 01; 187(4):828-836
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
04-01-2018
Author
Hannah Bower
Therese M-L Andersson
Michael J Crowther
Paul W Dickman
Mats Lambe
Paul C Lambert
Author Affiliation
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Source
Am J Epidemiol. 2018 04 01; 187(4):828-836
Date
04-01-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Aged
Aged, 80 and over
Breast Neoplasms - mortality
Data Interpretation, Statistical
Epidemiologic Research Design
Female
Humans
Linear Models
Male
Middle Aged
Risk factors
Social Class
Survival Analysis
Sweden
Uncertainty
Abstract
Expected or reference mortality rates are commonly used in the calculation of measures such as relative survival in population-based cancer survival studies and standardized mortality ratios. These expected rates are usually presented according to age, sex, and calendar year. In certain situations, stratification of expected rates by other factors is required to avoid potential bias if interest lies in quantifying measures according to such factors as, for example, socioeconomic status. If data are not available on a population level, information from a control population could be used to adjust expected rates. We have presented two approaches for adjusting expected mortality rates using information from a control population: a Poisson generalized linear model and a flexible parametric survival model. We used a control group from BCBaSe-a register-based, matched breast cancer cohort in Sweden with diagnoses between 1992 and 2012-to illustrate the two methods using socioeconomic status as a risk factor of interest. Results showed that Poisson and flexible parametric survival approaches estimate similar adjusted mortality rates according to socioeconomic status. Additional uncertainty involved in the methods to estimate stratified, expected mortality rates described in this study can be accounted for using a parametric bootstrap, but this might make little difference if using a large control population.
PubMed ID
29020167 View in PubMed
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[Adjusting for studied districts can be useful]

https://arctichealth.org/en/permalink/ahliterature24068
Source
Lakartidningen. 1993 Apr 28;90(17):1636-7
Publication Type
Article
Date
Apr-28-1993
Author
G. Steineck
T. Hakulinen
Source
Lakartidningen. 1993 Apr 28;90(17):1636-7
Date
Apr-28-1993
Language
Swedish
Publication Type
Article
Keywords
Breast Neoplasms - mortality - prevention & control
Data Interpretation, Statistical
Female
Humans
Mammography - statistics & numerical data
Mass Screening - statistics & numerical data
Models, Statistical
Sweden - epidemiology
Notes
Comment On: Lakartidningen. 1993 Feb 17;90(7):608-10; discussion 6117786323
Comment On: Lakartidningen. 1993 Feb 24;90(8):6848437487
PubMed ID
8487602 View in PubMed
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The Adjuvant Nutritional Intervention in Cancer (ANICA) Trial.

https://arctichealth.org/en/permalink/ahliterature276361
Source
Nutr Cancer. 2015;67(8):1355-8
Publication Type
Article
Date
2015
Author
Geir Bjørklund
Source
Nutr Cancer. 2015;67(8):1355-8
Date
2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Ascorbic Acid - administration & dosage
Breast Neoplasms - mortality - pathology - therapy
Chemotherapy, Adjuvant
Clinical Trials as Topic
Denmark
Fatty Acids, Essential - administration & dosage
Female
Humans
Lymphatic Metastasis
Middle Aged
Nutrition Therapy
Selenium - administration & dosage
Survival Rate
Trace Elements - administration & dosage
Ubiquinone - administration & dosage - analogs & derivatives
Vitamin E - administration & dosage
Vitamins - administration & dosage
beta Carotene - administration & dosage
Abstract
Adjuvant Nutritional Intervention in Cancer (ANICA) was a clinical study carried out in Denmark in the 1990s with 32 typical patients with breast cancer, aged 32-81 yr and classified high risk because of tumor spread to the lymph nodes. The patients received standard therapy for their breast cancer, but got from the start additionally an adjuvant therapy in form of a cocktail consisting of vitamin C (2,850 mg/day), vitamin E (2,500 IU/day), beta-carotene (32.5 IU/day), selenium (Se; 387 micrograms/day), various other vitamins and essential trace elements, essential fatty acids (1.2 g gamma-linolenic acid/day and 3.5 g omega-3 PUFAs/day), and coenzyme Q10 (CoQ10, 90 mg/day). The protocol was later changed, with reduction of the Se intake and more coenzyme Q10 than when the study was started. The average survival of high-risk breast patients in the study was 50% after 5 yr, whereas for low-risk breast cancer patients (without metastases in the axilla when treatment was started), the average survival was 90% after ten years. The main investigator died, and the final report from the ANICA study was therefore never written. However, the published preliminary results from the trial were very promising; it seems, therefore, important to follow-up this study.
PubMed ID
26473998 View in PubMed
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Adjuvant radiotherapy for breast cancer significantly improves overall survival: the missing link.

https://arctichealth.org/en/permalink/ahliterature20379
Source
Radiother Oncol. 2000 Jun;55(3):263-72
Publication Type
Article
Date
Jun-2000
Author
J. Van de Steene
G. Soete
G. Storme
Author Affiliation
Department of Radiotherapy, Oncology Centre AZ-VUB, Academic Hospital, Free University Brussels, Laarbeeklaan 101, Jette-Brussels, Belgium.
Source
Radiother Oncol. 2000 Jun;55(3):263-72
Date
Jun-2000
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - mortality - radiotherapy - surgery
Comparative Study
Denmark - epidemiology
Female
Humans
Mastectomy
Prospective Studies
Radiotherapy, Adjuvant - standards
Randomized Controlled Trials
Survival Rate - trends
Treatment Outcome
Abstract
BACKGROUND AND PURPOSE: The influence of surgical adjuvant radiotherapy on overall survival of patients with operable breast cancer is still a controversial subject. The negative result of the EBCTCG meta-analysis (Early breast cancer trialists', collaborative group. Effects of radiotherapy and surgery in early breast cancer. An overview of the randomised trials. N. Engl. J. Med. 1995;333:1444-1455) of clinical randomized trials on adjuvant radiotherapy in breast cancer is in strong contrast with the Danish 82B, 82C and British Columbia trials (Overgaard M, Hanse PS, Overgaar J, et al. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial. N. Engl. J. Med. 1997;337:949-955; Overgaard M, Jensen MB, Overgaard J, et al. Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomized trial. Lancet 1999;353:1641-1648; Ragaz J, Jackson S, Le N, et al. Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N. Engl. J. Med. 1997;337:956-962) showing an impressive survival benefit. This paper tries to fill in the gap between the conflicting results. MATERIALS AND METHODS: The 36 trials of the EBCTCG (Early breast cancer trialists', collaborative group, 1995) were prospectively screened for a number of objective parameters that are usually not analyzed in review papers. The odds of death data (and its variance) were borrowed from the original meta-analysis (Early breast cancer trialists', collaborative group, 1995) to check whether the objective features were significant predictors for overall survival benefit. RESULTS: A significant survival benefit for the radiotherapy arm was found for recent trials (2P
PubMed ID
10869741 View in PubMed
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Adult children's socioeconomic resources and mothers' survival after a breast cancer diagnosis: a Swedish population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature287819
Source
BMJ Open. 2017 Mar 30;7(3):e014968
Publication Type
Article
Date
Mar-30-2017
Author
Hannah L Brooke
Gunilla Ringbäck Weitoft
Mats Talbäck
Maria Feychting
Rickard Ljung
Source
BMJ Open. 2017 Mar 30;7(3):e014968
Date
Mar-30-2017
Language
English
Publication Type
Article
Keywords
Adult
Adult Children - statistics & numerical data
Aged
Breast Neoplasms - mortality
Cancer Survivors - statistics & numerical data
Educational Status
Female
Health Status Disparities
Humans
Income
Middle Aged
Mothers - statistics & numerical data
Socioeconomic Factors
Sweden - epidemiology
Abstract
Socioeconomic inequalities in survival after breast cancer persist worldwide. We aim to determine whether adult offspring's socioeconomic resources contribute to inequalities in mothers' survival after breast cancer.
14 231 women, aged 65-79 years, with a child aged =30 years and a first primary diagnosis of breast cancer in the National Cancer Register between 2001 and 2010 were followed until death, 10 years after diagnosis, or end of study (December 2015). Relative survival proportions and excess mortality within 10 years of diagnosis by strata of offspring's education level and disposable income were estimated using flexible parametric models accounting for measures of mothers' socioeconomic position and expected mortality in the general population.
4292 women died during 102 236 person-years of follow-up. Crude 10-year relative survival proportions for mothers of children with >14, 12-14 and 14 years of education, mothers of children with
Notes
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PubMed ID
28363931 View in PubMed
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Advanced breast cancer and breast cancer mortality in randomized controlled trials on mammography screening.

https://arctichealth.org/en/permalink/ahliterature147587
Source
J Clin Oncol. 2009 Dec 10;27(35):5919-23
Publication Type
Article
Date
Dec-10-2009
Author
Philippe Autier
Clarisse Héry
Jari Haukka
Mathieu Boniol
Graham Byrnes
Author Affiliation
Epidemiology and Biostatistics Cluster, International Agency for Research on Cancer, Lyon, France. pre@iarc.fr
Source
J Clin Oncol. 2009 Dec 10;27(35):5919-23
Date
Dec-10-2009
Language
English
Publication Type
Article
Keywords
Adult
Breast Neoplasms - mortality - radiography - secondary
Canada - epidemiology
Female
Great Britain - epidemiology
Humans
Incidence
Linear Models
Lymphatic Metastasis
Mammography
Middle Aged
Neoplasm Staging
Predictive value of tests
Randomized Controlled Trials as Topic
Risk assessment
Sweden - epidemiology
United States - epidemiology
Abstract
We assessed changes in advanced cancer incidence and cancer mortality in eight randomized trials of breast cancer screening.
Depending on published data, advanced cancer was defined as cancer > or = 20 mm in size (four trials), stage II+ (four trials), and > or = one positive lymph node (one trial). For each trial, we obtained the estimated relative risk (RR) and 95% CI between the intervention and control groups, for both breast cancer mortality and diagnosis of advanced breast cancer. Using a meta-regression approach, log(RR-mortality) was regressed on log(RR-advanced cancer), weighting each trial by the reciprocal of the square of the standard error of log(RR) for mortality.
RR for advanced breast cancer ranged from 0.69 (95% CI, 0.61 to 0.78) in the Swedish Two-County Trial to 0.97 (95% CI, 0.97 to 1.25) in the Canadian National Breast Screening Study-1 (NBSS-1) trial. Log(RR)s for advanced cancer were highly predictive of log(RR)s for mortality (R(2) = 0.95; P
PubMed ID
19884547 View in PubMed
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[Advantages and disadvantages of mammography screening of healthy women. A critical evaluation]

https://arctichealth.org/en/permalink/ahliterature26343
Source
Tidsskr Nor Laegeforen. 1986 Jun 30;106(19-21):1608-10, 15
Publication Type
Article
Date
Jun-30-1986
Author
K. Malterud
Source
Tidsskr Nor Laegeforen. 1986 Jun 30;106(19-21):1608-10, 15
Date
Jun-30-1986
Language
Norwegian
Publication Type
Article
Keywords
Adult
Age Factors
Breast Neoplasms - mortality
English Abstract
Evaluation Studies
Female
Humans
Mammography - economics
Middle Aged
Norway
PubMed ID
3764846 View in PubMed
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Age as a prognostic factor in breast cancer.

https://arctichealth.org/en/permalink/ahliterature26356
Source
Cancer. 1986 Jun 1;57(11):2217-21
Publication Type
Article
Date
Jun-1-1986
Author
H. Høst
E. Lund
Source
Cancer. 1986 Jun 1;57(11):2217-21
Date
Jun-1-1986
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Breast Neoplasms - mortality
Female
Humans
Middle Aged
Norway
Prognosis
Research Support, Non-U.S. Gov't
Abstract
The influence of age on survival was studied in an unselected series of 31,594 females with breast cancer reported to The Cancer Registry of Norway during 1955-1980. The prognosis was best in patients aged 35 to 49 years, and poorest in the older (greater than or equal to 75 years) and the younger patients (less than or equal to 34 years). These trends were present in all stages and periods of diagnosis. The poor outcome among the older patients may, in part, be related to less aggressive treatment, while differences in treatment procedures hardly explain the poor prognosis among the younger patients.
Notes
Erratum In: Cancer 1986 Aug 15;58(4):996
PubMed ID
3697919 View in PubMed
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505 records – page 1 of 51.