• CPR-2022/1888 Stichting Tegen Kanker
• CPR-2022/1888 Stichting Tegen Kanker
• CPR-2022/1888 Stichting Tegen Kanker
• CPR-2022/1888 Stichting Tegen Kanker
• CPR-2022/1888 Stichting Tegen Kanker
• CPR-2022/1888 Stichting Tegen Kanker

• breast cancer
• breast cancer screening
• intervention
• mammography
• screening uptake

• Breast cancer
• Breast density
• Diagnostic accuracy
• Lesion types
• Reader experience
• Screening mammograms

• Cancer screening
• Epidemiology
• Health economics
• Prostate cancer

• Västra Götalandsregionen

• early detection of cancer
• breast neoplasms
• health planning
• unified health system
• health services programming
• detecção precoce do câncer
• neoplasias da mama
• planejamento em saúde
• sistema único de saúde
• programação de serviços de saúde
• detección precoz del cáncer
• neoplasias de la mama
• planificación en salud
• sistema único de salud
• programación de servicios de salud

• Humans
• Brazil/epidemiology
• Female
• Cross-Sectional Studies
• Early Detection of Cancer
• Breast Neoplasms/diagnosis
• National Health Programs
• Mammography/statistics & numerical data
• Middle Aged
• Adult
• Mass Screening/methods
• Mass Screening/statistics & numerical data
• Health Services Accessibility/statistics & numerical data

• cardiovascular disease
• chronic obstructive pulmonary disease
• computed tomography
• lung cancer
• pulmonary infection
• radiography
• screening

• Humans
• Lung Neoplasms/diagnostic imaging
• Tomography, X-Ray Computed/methods
• Japan/epidemiology
• Radiography, Thoracic/methods
• Early Detection of Cancer/methods
• Radiation Dosage
• Thoracic Diseases/diagnostic imaging
• Mass Screening/methods
• Pulmonary Disease, Chronic Obstructive/diagnostic imaging

• Breast cancer
• Breast density
• Cancer screening
• Digital Breast Tomosynthesis
• Risk assessment

• Humans
• Female
• Breast Neoplasms/diagnostic imaging
• Mammography/methods
• Middle Aged
• Prospective Studies
• Early Detection of Cancer/methods
• Breast Density
• Italy
• Risk Assessment
• Mass Screening/methods
• Risk Factors

• 968/DGR of Jul 06 Regione del Veneto
• 2018 Regione del Veneto

• Breast cancer
• Europe
• Incidence
• Mortality
• Screening program
• Take-up

• Female
• Humans
• Breast Neoplasms/diagnosis
• Breast Neoplasms/epidemiology
• Early Detection of Cancer
• Europe/epidemiology
• Incidence
• Mammography
• Mass Screening
• Mortality

• Mammography
• Radiologists
• Survey and questionnaires
• Workload
• Workplace

• Humans
• Female
• Radiologists
• Mammography/methods
• Breast
• Surveys and Questionnaires
• Europe
• Breast Neoplasms/diagnostic imaging
• Mass Screening

• cancer control
• mammography
• periodic survival
• treatment

We evaluated the short-term effectiveness of a mammography screening program in all women who participated in the screening program and were diagnosed with screen-detected or interval breast cancer (BC) in Flanders (2008–2018). The evaluation was performed for the major molecular subtypes of invasive BC separately and considering the regularity of participation. We found that screen-detected BC was more likely to be diagnosed at early stages than interval BC of luminal, luminal-HER2-positive, and triple-negative BC (TNBC) type, but not for the human epidermal growth factor receptor 2-positive (HER2 positive) subtype. In addition, regular participation was related to a higher likelihood of screening detection than irregular participation for luminal, luminal-HER2-positive, and TNBC, but not for the HER2 positive subtype, either. Our results indicate that regular screening as compared to irregular screening is effective for all breast cancers except for the HER2 subtype.

Background: Screening program effectiveness is generally evaluated for breast cancer (BC) as one disease and without considering the regularity of participation, while this might have an impact on detection rate. Objectives: To evaluate the short-term effectiveness of a mammography screening program for the major molecular subtypes of invasive BC. Methods: All women who participated in the screening program and were diagnosed with screen-detected or interval BC in Flanders were included in the study (2008–2018). Molecular subtypes considered were luminal and luminal-HER2-positive, human epidermal growth factor receptor 2-positive, and triple-negative BC (TNBC). The relationship between the BC stage at diagnosis (early (I–II) versus advanced (III–IV)) and the method of detection (screen-detected or interval) and the relationship between the method of detection and participation regularity (regular versus irregular) were evaluated by multi-variable logistic regression models. All models were performed for each molecular subtype and adjusted for age. Results: Among the 12,318 included women, BC of luminal and luminal-HER2-positive subtypes accounted for 70.9% and 11.3%, respectively. Screen-detected BC was more likely to be diagnosed at early stages than interval BC with varied effect sizes for luminal, luminal-HER2-positive, and TNBC with OR:2.82 (95% CI: 2.45–3.25), OR:2.39 (95% CI: 1.77–3.24), and OR:2.29 (95% CI: 1.34–4.05), respectively. Regular participation was related to a higher likelihood of screening detection than irregular participation for luminal, luminal-HER2-positive, and TNBC with OR:1.21 (95% CI: 1.09–1.34), OR: 1.79 (95% CI: 1.38–2.33), and OR: 1.62 (95% CI: 1.10–2.41), respectively. Conclusions: Regular screening as compared to irregular screening is effective for all breast cancers except for the HER2 subtype.

• chronic obstructive pulmonary disease
• computed tomography
• lung cancer
• pulmonary infection
• radiography
• screening
• thoracic disease

• Early Detection of Cancer/methods
• Female
• Humans
• Lung Neoplasms/diagnostic imaging
• Male
• Mass Screening
• Middle Aged
• Pulmonary Disease, Chronic Obstructive
• Radiography, Thoracic
• Thoracic Diseases/diagnostic imaging
• Tomography, X-Ray Computed

• Breast cancer
• Germany
• Russia
• Stage at diagnosis

• Breast/pathology
• Breast Neoplasms/diagnosis
• Breast Neoplasms/epidemiology
• Breast Neoplasms/pathology
• Early Detection of Cancer/methods
• Female
• Germany/epidemiology
• Humans
• Incidence
• Mammography/methods
• Mass Screening/methods
• Registries

• Breast neoplasms
• Digital mammography
• Neoplasm staging
• Regularity
• Screening participation

Breast cancer (BC) screening can be performed in a screening program (BCSP) or in opportunistic screening. The existing reviews on the determinants of non-participation depend on self-reported data which may be biased. Furthermore, no distinction was made between the probably different determinants of both screening strategies.

To find the determinants of non-participation in BCSP by means of a meta-analysis.

PubMed, Embase, and Web of Science were searched for observational studies which quantified factors associated with non-participation in BCSP in a general population. Studies on opportunistic screening and studies using self-reported data were excluded. A random-effect model was used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Potential sources of heterogeneity were explored by stratification of the results.

Twenty-nine studies with in a total of 20,361,756 women were included. Low income (OR: 1.20, 95% CI: 1.10–1.30), low education (OR: 1.18, 95% CI: 1.05–1.32), living far from an assigned screening unit (OR: 1.15, 95% CI: 1.07–1.24), being immigrant (OR: 2.64, 95% CI: 2.48–2.82), and having a male family doctor (OR: 1.43, 95% CI: 1.20–1.61) was associated with higher non-participation in screening. Reminders sent to non-attenders and estimations of ORs (adjusted or not) partly explained substantial heterogeneity.

In this meta-analysis excluding studies on the non-participation in opportunistic screening, or with self-reported data on non-participation, the well-known determinants for non-participation are still significant, but less strong. This analysis only supports the relevance of meta-analysis of studies with registered non-participation in a BCSP.

PROSPERO, CRD42020154016.

• breast cancer
• determinant
• mammography
• mass screening
• participation

• Chinese women
• breast cancer screening
• diagnostic performance
• participation rate
• real-world study

Background: In Flanders, breast cancer (BC) screening is performed in a population-based breast cancer screening program (BCSP), as well as in an opportunistic setting. Women with different socio-demographic characteristics are not equally covered by BC screening.

Objective: To evaluate the role of socio-demographic characteristics on the lowest 10th and highest 90th quantile levels of BC screening coverage.

Methods: The 2017 neighborhood-level coverage rates of 8,690 neighborhoods with women aged 50–69 and eligible for BCSP and opportunistic screening were linked to socio-demographic data. The association between socio-demographic characteristics and the coverage rates of BCSP and opportunistic screening was evaluated per quantile of coverage using multivariable quantile regression models, with specific attention to the lowest 10th and highest 90th quantiles.

Results: The median coverage in the BCSP was 50%, 33.5% in the 10th quantile, and 64.5% in the 90th quantile. The median coverage of the opportunistic screening was 12, 4.2, and 24.8% in the 10th and 90th quantile, respectively. A lower coverage of BCSP was found in neighborhoods with more foreign residents and larger average household size, which were considered indicators for a lower socioeconomic status (SES). However, a higher average personal annual income, which was considered an indicator for a higher SES, was also found in neighborhoods with lower coverage of BCSP. For these neighborhoods, that have a relatively low and high SES, the negative association between the percentage of foreign residents, average household size, and average personal annual income and the coverage in the BCSP had the smallest regression coefficient and 95% confidence interval (CI) values were −0.75 (95% CI: −0.85, −0.65), −13.59 (95% CI: −15.81, −11.37), and −1.05 (95% CI: −1.18, −0.92), respectively, for the 10th quantile. The neighborhoods with higher coverage of opportunistic screening had a relatively higher average personal annual income, with the largest regression coefficient of 1.72 (95% CI: 1.59, 1.85) for the 90th quantile.

Conclusions: Women from relatively low and high SES neighborhoods tend to participate less in the BCSP, whereas women with a relatively high SES tend to participate more in opportunistic screening. For women from low SES neighborhoods, tailored interventions are needed to improve the coverage of BCSP.

• breast cancer
• coverage
• determinant
• mammography screening
• quantile regression
• social inequality

• Artificial intelligence
• Breast cancer
• Mammography
• Mass screening

• Artificial Intelligence
• Breast Neoplasms/diagnostic imaging
• Early Detection of Cancer
• Humans
• Mammography
• Mass Screening
• Prospective Studies
• Retrospective Studies

• Lund University

Breast cancer (BC) is the leading malignant tumor among women worldwide. Although attending regular BC screening effectively reduces cancer-related mortality, surveys testify that screening knowledge is critically low among women. We aimed to conduct a comparative cross-sectional survey to assess BC and BC screening-related knowledge in Hungary.

Women between 25 and 65 years of age without a previous history of malignant tumors were included with non-probability sampling in 2017. Respondents were recruited either from primary care (laywomen) or from the waiting rooms of mammography (screening attendees). A self-completion questionnaire was constructed with questions about BC (risk factors, signs and symptoms, curability, and mortality), BC screening (mammography and breast self-examination), and BC-related information sources to assess knowledge among laywomen and screening attendees. In addition to descriptive statistics, odds ratios with 95% confidence intervals were calculated in univariate analysis and logistic regression was used in multivariate analysis.

Altogether, 480 women completed the questionnaire, of which 429 (227 laywomen and 202 screening attendees) were eligible for inclusion. Laywomen and screening attendees knew the recommended age at first mammography in 35.2% and 86.6%, the recommended frequency of screening in 33.9% and 12.9%, the recommended age at first breast-self examination in 38.8% and 51.2%, had sufficient knowledge of the risk factors of BC in 7.0% and 5.9%, and that of signs and symptoms of BC in 16.7% and 28.9%, respectively. A higher proportion of screening attendees correctly identified the recommended age of first BC screening correctly than that of laywomen (86.6% vs. 35.2%; p < 0.001). The most popular information sources were television among laywomen and general practitioners or specialists among screening attendees. In multivariate analysis, older age, higher education, and place of residency were significant predictors of the right answers.

Although knowledge was insufficient in almost all fields of the questionnaire, the most prominent gap was observed concerning risk factors and signs and symptoms of BC both in laywomen and, unexpectedly, screening attendees. Most laywomen were lacking knowledge of screening protocol. These results urge breast health and BC knowledge interventions in Hungary.

The online version contains supplementary material available at 10.1186/s12905-021-01204-9.

• Breast cancer screening
• Knowledge
• Mammography

국가암검진사업에서 매년 400만 명 이상의 여성이 유방촬영술을 이용한 유방암 검진을 받고 있다. 2000년 디지털 유방촬영술의 도입 이후, 선행 연구들에 의하면 디지털 유방촬영술은 치밀유방을 가진 여성에서 제한적으로 기존의 필름 방식 또는 computed radiography (이하 CR)보다 높은 진단 정확도를 보고하였다. 최근 국가암검진사업에서 수행된 자료를 분석한 결과에 따르면 디지털 유방촬영술의 진단 정확도가 필름 또는 CR 방식에 비해서 치밀유방을 가진 여성뿐만 아니라 모든 연령대의 여성에서 검진 횟수와 상관없이 보다 정확하였다. 우리나라는 OECD 국가 중에서도 높은 유방촬영기기 보급률에도 불구하고 현재 디지털 유방촬영기기의 보급은 전체 유방촬영기기 중, 35% 정도 수준으로 더디기만 하다. 디지털 유방촬영기기로의 신속한 전환을 위하여 수가제도의 개선, 유방 영상 판독 교육 지원 등 관련법과 제도의 정비가 필요할 것이다. 아울러 국가암검진사업에서 보다 많은 여성이 디지털 유방촬영기기를 이용한 유방암 검진을 받을 수 있도록 장비 보급의 지역 간 격차 해소를 위해 노력해야 할 것이다.

Breast cancer (BC) is the most common cancer in women in the developed world. In order to find developing cancers in an early stage, BC screening is commonly used. In Flanders, screening is performed in and outside an organized breast cancer screening program (BCSP). However, the determinants of BC screening coverage for both screening strategies are yet unknown.

To assess the determinants of BC screening coverage in Flanders.

Reimbursement data were used to attribute a screening status to each woman in the target population for the years 2008–2016. Yearly coverage data were categorized as screening inside or outside BCSP or no screening. Data were clustered by municipality level. A generalized linear equation model was used to assess the determinants of screening type.

Over all years and municipalities, the median screening coverage rate inside and outside BCSP was 48.40% (IQR: 41.50–54.40%) and 14.10% (IQR: 9.80–19.80%) respectively. A higher coverage rate outside BSCP was statistically significantly (P < 0.001) associated with more crowded households (OR: 3.797, 95% CI: 3.199–4.508), younger age, higher population densities (OR: 2.528, 95% CI: 2.455–2.606), a lower proportion of unemployed job seekers (OR: 0.641, 95% CI: 0.624–0.658) and lower use of dental care (OR: 0.969, 95% CI: 0.967–0.972).

Coverage rate of BC screening is not optimal in Flanders. Women with low SES that are characterized by younger age, living in a high population density area, living in crowded households, or having low dental care are less likely to be screened for BC in Flanders. If screened, they are more likely to be screened outside the BCSP.

• Breast neoplasms
• Coverage rate
• Mammography
• Mass screening
• Social determinants of health

• China
• awareness
• breast cancer
• health information literacy
• influential factors
• screening

• Mammography
• attendance
• attendance patterns
• breast neoplasm
• screening

• breast CT
• contrast enhanced
• iodine quantification
• photon-counting
• spectral imaging

• breast cancer
• incidence-based mortality
• mammography
• screening

• 27047 Cancer Research UK

• Breast cancer
• Mammography screening programme
• Migrants
• Participation
• Resettlers
• Stage at diagnosis

• Adult
• Aged
• Breast Neoplasms/epidemiology
• Chi-Square Distribution
• Cohort Studies
• Cross-Sectional Studies
• Early Detection of Cancer/methods
• Early Detection of Cancer/statistics & numerical data
• Female
• Germany/epidemiology
• Humans
• Incidence
• Mammography/statistics & numerical data
• Middle Aged
• Odds Ratio
• Patient Acceptance of Health Care/ethnology
• Registries
• Retrospective Studies
• Transients and Migrants/statistics & numerical data
• USSR/ethnology

• NKP-332-028 Federal Ministry of Health
• 111232 German Cancer Aid

Increased knowledge of breast cancer risk factors has meant that we are currently exploring risk-based screening, i.e. determining screening strategies based on women’s varying levels of risk. This also enables risk management through primary prevention strategies, e.g. a lifestyle programme or risk-reducing medication. However, future implementation of risk-based screening and prevention will warrant significant changes in current practice and policy. The present study explores women’s perceptions of the implementation and organisation of risk-based breast cancer screening and prevention to optimise acceptability and uptake.

A total of 143 women eligible for breast cancer screening in the Netherlands, the United Kingdom, and Sweden participated in focus group discussions. The focus group discussions were transcribed verbatim and the qualitative data was analysed using thematic analysis.

Women from all three countries generally agreed on the overall proceedings, e.g. a risk assessment after which the risk estimate is communicated via letter (for below average and average risk) or consultation (for moderate and high risk). However, discrepancies in information needs, preferred risk communication format and risk counselling professional were identified between countries. Additionally, a need to educate healthcare professionals on all aspects of the risk-based screening and prevention programme was established.

Women’s insights identified the need for country-specific standardised protocols regarding the assessment and communication of risk, and the provision of heterogeneous screening and prevention recommendations, monitoring the principle of solidarity in healthcare policy.

• Breast cancer
• Implementation
• Primary prevention
• Risk stratification
• Screening

• Breast cancer mortality
• Breast cancer screening
• Systematic review

• Artificial Intelligence/standards
• Breast Neoplasms/diagnostic imaging
• Early Detection of Cancer/methods
• Early Detection of Cancer/standards
• Female
• Humans
• Mammography/standards
• Reproducibility of Results
• United Kingdom
• United States

• 09/22/182 Department of Health
• 17321 Cancer Research UK
• 26884 Cancer Research UK
• 28396 Cancer Research UK

• breast cancer
• help-seeking
• mammography
• meta-analysis
• screening

• Anthropometric factors
• Breast cancer screening
• In situ ductal breast cancer
• Mammography
• Menopausal status
• Reproductive factors

• breast cancer
• discriminative CpG dinucleotides
• early detection
• hypermethylation
• liquid biopsy

• Aged
• Breast Neoplasms/diagnosis
• Breast Neoplasms/psychology
• Choice Behavior
• Early Detection of Cancer/methods
• Early Detection of Cancer/psychology
• Early Detection of Cancer/statistics & numerical data
• Female
• Health Policy
• Humans
• Mammography/psychology
• Mammography/statistics & numerical data
• Middle Aged
• Patient Preference/psychology
• Patient Preference/statistics & numerical data
• Physical Examination/psychology
• Physical Examination/statistics & numerical data
• Republic of Belarus

• 001 World Health Organization
• International Agency for Research on Cancer

• breast cancer
• cancer registry data
• geographic variations
• health insurance claims data
• incidence
• mammography screening
• participation
• screening unit data

• Cardiovascular diseases
• Mammography
• Mass screening
• Medial calcific sclerosis
• Monckeberg
• Risk assessment

• breast cancer
• mammography screening
• mapping
• opportunistic screening
• socioeconomic inequalities
• spatial variation

• Aged
• Breast Neoplasms/diagnosis
• Breast Neoplasms/prevention & control
• Early Detection of Cancer/statistics & numerical data
• Female
• France/epidemiology
• Geography
• Humans
• Mammography/statistics & numerical data
• Mass Screening/statistics & numerical data
• Middle Aged
• Risk Factors

Triggered by the successive implementation of organized mammography screening programs (MSPs) throughout western European countries over the last decades, there is an ongoing debate questioning their effectiveness. Since it is difficult to assess the effect of MSPs on a population level, we rather aim to assess the impact of the implementation itself on breast cancer mortality rates utilizing an ecological study design.

We analyzed age group-specific (50–59, 60–69 and 70–79 years) female breast cancer mortality rates in 14 western European countries between 1980 and 2017 using Joinpoint regression, interrupted time series (ITS) regression and multivariable Poisson regression.

The Joinpoint analysis demonstrated decreasing trends resulting in annual percentage changes ranging from − 1.5% to − 5.4% (50–59), − 0.2% to − 8.1% (60–69) and 0% to − 7.1% (70–79) depending on the country within 3 years after MSP implementation. The ITS analysis results in highly significant interaction terms (calendar year * binary MSP indicator) for all age groups. The multivariable regression using “calendar year”, “year of MSP implementation” and “years with MSP” as independent variables yielded a significant yearly decrease for “years with MSP” ranging from 0.9 to 1.2%.

The results of this study suggest a positive association between the implementation of MSPs and the (accelerated) reduction of breast cancer mortality rates. Measuring and quantifying the isolated effect of MSPs on a population level will require additional studies using individual data.

• Breast cancer
• Europe
• Mammography screening
• Mortality