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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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[600,000 women are examined by mammography per year. Every fifth of them refuses screening].

https://arctichealth.org/en/permalink/ahliterature215813
Source
Lakartidningen. 1995 Feb 8;92(6):552-6
Publication Type
Article
Date
Feb-8-1995

1991-1996: Alaska's progress towards the goals of Healthy People 2000

https://arctichealth.org/en/permalink/ahliterature88238
Source
Alaska's Behavioral Risk Factor Surveillance System 6(1)
Publication Type
Report
Date
Feb-1998
Author Affiliation
State of Alaska Department of Health and Social Services
Source
Alaska's Behavioral Risk Factor Surveillance System 6(1)
Date
Feb-1998
Language
English
Geographic Location
U.S.
Publication Type
Report
Physical Holding
University of Alaska Anchorage
Keywords
Behavioral risk factors
Cholesterol screening
Cigarette smoking
Diabetes
Fruit and vegetable consumption
Heart disease
Inflluenza amd pneumonia immunizations
Mammography and clinical breast exams
Overweight
Pap tests
Physical activity
Proctoscopic exams
Safety belt use
Abstract
The Alaska Department of Health and Social Services implemented the Behavioral Risk Factor Surveillance System (BRFSS) in 1990 incooperation with the federal Centers for Disease Control and Prevention. The system gathers information about the health-related lifestyle choices of Alaskan adults related to leading causes of death such as heart disease, cancer and injury. The program is part of an ongoing national data collection system. Results are analyzed each year to improve our understanding of Alaskanhealth habits and to measure progress toward national and state health objectives. This report summarizes survey findings from1991 to 1996 and compares the results to selected national health objectives presented in the Healthy People 2000 publication.
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[Acceptance of mammographic screening by immigrant women]

https://arctichealth.org/en/permalink/ahliterature19313
Source
Ugeskr Laeger. 2002 Jan 7;164(2):195-200
Publication Type
Article
Date
Jan-7-2002
Author
Ida Kristine Holk
Nils Rosdahl
Karen L Damgaard Pedersen
Author Affiliation
Embedslaegeinstitutionen for Københavns, Frederiksberg Kommuner, Henrik Pontoppidansvej 8, DK-2200 København N.
Source
Ugeskr Laeger. 2002 Jan 7;164(2):195-200
Date
Jan-7-2002
Language
Danish
Publication Type
Article
Keywords
Aged
Attitude to Health
Breast Neoplasms - prevention & control - psychology - radiography
Comparative Study
Denmark - epidemiology - ethnology
Emigration and Immigration
English Abstract
Female
Humans
Mammography - psychology - statistics & numerical data
Mass Screening - methods - psychology - statistics & numerical data
Middle Aged
Pakistan - ethnology
Patient compliance
Poland - ethnology
Turkey - ethnology
Yugoslavia - ethnology
Abstract
BACKGROUND: The aim was to investigate compliance by ethnic groups to the mammography screening programme in the City of Copenhagen over six years and to look at developments over time. MATERIAL AND METHODS: Mammography screening has, since 1 April 1991, been offered free of charge to all women between 50 and 69 years of age in the City of Copenhagen. Data on women born in Poland, Turkey, Yugoslavia, and Pakistan divided into five-year groups were compared to that of women born in Denmark and all other foreign-born women. Data from 1991 to 1997 were grouped according to the mammography performed, the offer refused, or non-appearance. RESULTS: Whereas 71% of Danish-born women accepted mammography, compliance by foreign-born women was significantly lower. The offer was accepted by 36% of Pakistanis, 45% of Yugoslavians, 53% of Turks, and 64% of Poles. Compliance fell in all ethnic groups with advancing age. Of the Danish women, 16% failed to keep the appointment. The corresponding percentages were 52 for Pakistanis, 48 for Yugoslavians, 41 for Turks, and 23 for Poles. The proportion of women who actively refused the offer was similar in all groups. The number of invited women fell during the period. CONCLUSIONS: The lower participation of women from the countries under study might have various explanations: among them the language barrier, procedure-related factors, and a lower incidence of breast cancer in the countries of origin.
PubMed ID
11831089 View in PubMed
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Access to breast cancer screening programs for women with disabilities.

https://arctichealth.org/en/permalink/ahliterature128355
Source
J Health Care Poor Underserved. 2012 Nov;23(4):1609-19
Publication Type
Article
Date
Nov-2012
Author
Renée Proulx
Céline Mercier
Fanny Lemétayer
Sylvie Jutras
Diane Major
Author Affiliation
CRDITED de Montréal, 75, rue de Port-Royal Est, bureau 110, Montréal, Québec, Canada H3L 3T1. renee.proulx@crditedmtl.ca
Source
J Health Care Poor Underserved. 2012 Nov;23(4):1609-19
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Aged
Breast Neoplasms - diagnosis
Delphi Technique
Disabled persons - statistics & numerical data
Early Detection of Cancer - statistics & numerical data
Female
Health Services Accessibility - statistics & numerical data
Humans
Interviews as Topic
Mammography - statistics & numerical data
Middle Aged
Quebec
Abstract
The goal of this study was to identify measures to facilitate access to the Quebec Breast Cancer Screening Program for women with activity limitations, considering the barriers to screening uptake in that population.
The study was carried out in three stages. First, 124 semi-structured interviews were conducted in five regions of Quebec with five groups of key informants. The content analysis lead to the identification of 64 proposals, which were submitted to 31 experts through a two-round Delphi survey process. Finally, consultations were held with 11 resource people to determine which decision-making levels (local, regional, provincial) could play a key role in implementing the proposals.
A strong consensus (=80%) was achieved for 25 proposals seen as highly relevant and feasible.
The implementation of such proposals could substantially improve access to screening, given the prevalence of activity limitations in the age group targeted by the program.
PubMed ID
23698675 View in PubMed
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Access to medical care: how do women in Canada and the United States compare?

https://arctichealth.org/en/permalink/ahliterature115809
Source
Prev Med. 2013 May;56(5):345-7
Publication Type
Article
Date
May-2013
Author
Karen Buhr
Author Affiliation
Penn State Harrisburg, School of Public Affairs, Middletown, PA 17057, USA. kjb44@psu.edu
Source
Prev Med. 2013 May;56(5):345-7
Date
May-2013
Language
English
Publication Type
Article
Keywords
Aged
Breast Neoplasms - prevention & control
Canada
Early Detection of Cancer - utilization
Female
Health Services Accessibility - statistics & numerical data
Humans
Insurance Coverage - statistics & numerical data
Mammography - utilization
Medically Uninsured - statistics & numerical data
Middle Aged
United States
Uterine Cervical Neoplasms - prevention & control
Vaginal Smears - utilization
Abstract
The purpose of this study is to determine if access to medical care and utilization of cancer screenings differs between women in the United States and Canada. This study examined this question by comparing women in Canada to women in the United States who have insurance coverage and those who do not.
This study used data from the 2002/03 Joint Canada United States Survey of Health and examined access to medical care and cancer screenings. A binary probit model was used to address several measures of access to medical care and cancer screening utilization.
This study finds five significant differences between insured American and Canadian women. Canadian women are better off in terms of ever having a mammogram, having a regular doctor, and having access to needed medicine, but fare worse in terms of having had a recent mammogram and having perceived unmet healthcare needs. With the exception of having recent mammograms, there is no statistical difference between uninsured and insured American women.
Although this study does not show that one group is strictly better off, it does show that there are significant differences between the two groups of women.
PubMed ID
23462478 View in PubMed
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ACS keeps mammography guidelines for women under 50.

https://arctichealth.org/en/permalink/ahliterature221477
Source
J Natl Cancer Inst. 1993 Mar 3;85(5):348-9
Publication Type
Article
Date
Mar-3-1993

Adaptation to Swedish and further development of the 'Consequences of Screening - Breast Cancer' questionnaire: a multimethod study.

https://arctichealth.org/en/permalink/ahliterature122551
Source
Scand J Caring Sci. 2013 Jun;27(2):475-86
Publication Type
Article
Date
Jun-2013
Author
Anetta Bolejko
Christine Wann-Hansson
Sophia Zackrisson
John Brodersen
Peter Hagell
Author Affiliation
Department of Health Sciences, Lund University, Lund, Sweden. anetta.bolejko@med.lu.se
Source
Scand J Caring Sci. 2013 Jun;27(2):475-86
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - physiopathology - radiography
Female
Humans
Mammography - psychology
Questionnaires
Sweden
Translating
Abstract
Experiencing a false-positive screening mammography can cause considerable psychosocial distress. The Consequences of Screening - Breast Cancer questionnaire (COS-BC parts 1 and 2), recently developed in Denmark, is the only condition-specific questionnaire for measuring short- and long-term psychosocial consequences of false-positive mammographic screening. Additional studies are needed to further test the COS-BC before use across cultures. Furthermore, studies have suggested that the consequences of false-positive screening results are partly common across cancer screening settings, although this hypothesis remains largely untested.
This study (i) assesses content validity of a Swedish version of the COS-BC, (ii) tests whether items expressing long-term consequences of false-positive lung cancer screening results are relevant in a breast cancer screening context and (iii) explores the usefulness of taking results from Rasch analyses of the source version as an aid in questionnaire translation and adaptation.
Following dual-panel translation, content validity was assessed through qualitative interviews with representatives of the target population and the content validity index (CVI). Item locations and Rasch model fit of the source questionnaires were considered in the translation and assessment process.
The COS-BC items were generally found relevant and provided coverage of the target construct. Content validity was supported also for nine of 10 lung cancer screening items. Scale CVI values were =0.81. Previous Rasch data were useful in facilitating translation and assessing item content validity. The resulting Swedish version of the COS-BC parts 1 and 2 consists of 34 and 23 items, respectively.
This study illustrates the value of methodological triangulation and use of data from previous Rasch analyses in questionnaire translation and adaptation. We found support for the hypothesis that consequences of false-positive screening are common across cancer screening settings. Psychometric properties of the Swedish COS-BC remain to be established.
PubMed ID
22804720 View in PubMed
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Adherence to breast and ovarian cancer screening recommendations for female relatives from the Ontario site of the Breast Cancer Family Registry.

https://arctichealth.org/en/permalink/ahliterature133576
Source
Eur J Cancer Prev. 2011 Nov;20(6):492-500
Publication Type
Article
Date
Nov-2011
Author
Michael A Campitelli
Anna M Chiarelli
Lucia Mirea
Lindsay Stewart
Gord Glendon
Paul Ritvo
Irene L Andrulis
Julia A Knight
Author Affiliation
Prevention and Cancer Control, Cancer Care Ontario, Toronto, Canada.
Source
Eur J Cancer Prev. 2011 Nov;20(6):492-500
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - diagnosis - epidemiology - genetics
Cohort Studies
Cross-Sectional Studies
Early Detection of Cancer - standards
Female
Genetic Testing - standards
Humans
Mammography - standards
Middle Aged
Ontario - epidemiology
Ovarian Neoplasms - diagnosis - epidemiology - genetics
Patient compliance
Registries
Young Adult
Abstract
This study compares adherence to breast and ovarian cancer screening recommendations among a population cohort of women at familial risk of breast and/or ovarian cancer. This cross-sectional study included 1039 first-degree female relatives without breast cancer identified from the Ontario site of the Breast Cancer Family Registry. We compared breast and ovarian cancer screening behaviors, using a telephone-administered questionnaire among three groups of women defined by their familial risk (high, moderate, and low) of breast and/or ovarian cancer. Associations between screening behaviors and familial risk were assessed using multinomial regression models adjusted by familial clustering. Women, 40-49 years of age, at moderate or high familial risk were significantly more likely to have had a screening mammogram within the past 12 months [odds ratio (OR): 2.80; 95% confidence interval (CI): 1.40-5.58], and women of less than 50 years of age were more likely to have a clinical breast examination (OR: 1.84; 95% CI: 1.02-3.31) compared with women at low familial risk. Compared with women at low or moderate familial risk, women at high familial risk were significantly more likely to have ever had a genetic test for the BRCA 1/2 genes (OR: 2.67; 95% CI: 1.76-4.05). Although the overall level of adherence among high-risk women is suboptimal in the community, women at a higher familial risk are adhering more often to cancer screening recommendations than women at a lower familial risk.
Notes
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PubMed ID
21691207 View in PubMed
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Adjusting for BMI in analyses of volumetric mammographic density and breast cancer risk.

https://arctichealth.org/en/permalink/ahliterature300458
Source
Breast Cancer Res. 2018 12 29; 20(1):156
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
12-29-2018
Author
Sue Hudson
Kirsti Vik Hjerkind
Sarah Vinnicombe
Steve Allen
Cassia Trewin
Giske Ursin
Isabel Dos-Santos-Silva
Bianca L De Stavola
Author Affiliation
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. susan.hudson@lshtm.ac.uk.
Source
Breast Cancer Res. 2018 12 29; 20(1):156
Date
12-29-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adiposity
Aged
Aged, 80 and over
Body mass index
Breast - diagnostic imaging - pathology
Breast Density
Breast Neoplasms - diagnostic imaging - pathology
Case-Control Studies
Cohort Studies
Feasibility Studies
Female
Humans
Image Processing, Computer-Assisted - methods
Logistic Models
Mammography - methods
Mass Screening - methods
Middle Aged
Norway
Risk assessment
Risk factors
United Kingdom
Abstract
Fully automated assessment of mammographic density (MD), a biomarker of breast cancer risk, is being increasingly performed in screening settings. However, data on body mass index (BMI), a confounder of the MD-risk association, are not routinely collected at screening. We investigated whether the amount of fat in the breast, as captured by the amount of mammographic non-dense tissue seen on the mammographic image, can be used as a proxy for BMI when data on the latter are unavailable.
Data from a UK case control study (numbers of cases/controls: 414/685) and a Norwegian cohort study (numbers of cases/non-cases: 657/61059), both with volumetric MD measurements (dense volume (DV), non-dense volume (NDV) and percent density (%MD)) from screening-age women, were analysed. BMI (self-reported) and NDV were taken as measures of adiposity. Correlations between BMI and NDV, %MD and DV were examined after log-transformation and adjustment for age, menopausal status and parity. Logistic regression models were fitted to the UK study, and Cox regression models to the Norwegian study, to assess associations between MD and breast cancer risk, expressed as odds/hazard ratios per adjusted standard deviation (OPERA). Adjustments were first made for standard risk factors except BMI (minimally adjusted models) and then also for BMI or NDV. OPERA pooled relative risks (RRs) were estimated by fixed-effect models, and between-study heterogeneity was assessed by the I2 statistics.
BMI was positively correlated with NDV (adjusted r = 0.74 in the UK study and r = 0.72 in the Norwegian study) and with DV (r = 0.33 and r = 0.25, respectively). Both %MD and DV were positively associated with breast cancer risk in minimally adjusted models (pooled OPERA RR (95% confidence interval): 1.34 (1.25, 1.43) and 1.46 (1.36, 1.56), respectively; I2 = 0%, P >0.48 for both). Further adjustment for BMI or NDV strengthened the %MD-risk association (1.51 (1.41, 1.61); I2 = 0%, P = 0.33 and 1.51 (1.41, 1.61); I2 = 0%, P = 0.32, respectively). Adjusting for BMI or NDV marginally affected the magnitude of the DV-risk association (1.44 (1.34, 1.54); I2 = 0%, P = 0.87 and 1.49 (1.40, 1.60); I2 = 0%, P = 0.36, respectively).
When volumetric MD-breast cancer risk associations are investigated, NDV can be used as a measure of adiposity when BMI data are unavailable.
PubMed ID
30594212 View in PubMed
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1242 records – page 1 of 125.