Article

Breast-cancer mortality in a non-randomized trial on mammographic screening in women over age 65.

National Expert and Training Centre for Breast Cancer Screening in the Netherlands, Nijmegen.
International Journal of Cancer (impact factor: 5.44). 02/1997; 70(2):164-8. pp.164-8
Source: PubMed

ABSTRACT Recent case-referent studies in the Nijmegen breast-screening programme have shown a reduction in breast-cancer mortality of approximately 50% due to screening of women aged 65 years and older. In this type of study, however, the results may be biased because of self-selection. The purpose of our present study was to compare the breast-cancer mortality rate in a population invited for screening with that of a reference population from an area without a screening programme. In 1977-1978, 6773 women aged 68-83 years were enrolled in the mammographic screening programme in Nijmegen, The Netherlands. The women were followed up until 31 December, 1990. The reference population consisted of women from the same birth cohort from Arnhem, a neighbouring city without mass screening, for whom the entry date was 1 January, 1978. The ratios of the Nijmegen and Arnhem breast-cancer mortality rates with 95% confidence intervals (CI) were calculated. In the study period, 173 patients were diagnosed with primary breast cancer in Nijmegen vs. 183 in Arnhem; 40 Nijmegen patients had died of breast cancer vs. 51 Arnhem patients. The cumulative mortality-rate ratio was 0.80 (95% CI = 0.53-1.22). In the periods 1978-1981, 1982-1985 and 1986-1990, the mortality rate ratios were 1.44 (95% CI = 0.67-3.10), 081 (95% CI = 0.37-1.79) and 0.53 (95% CI = 0.27-1.04), respectively. After adjustment for the difference in incidence rate that existed between the Nijmegen and Arnhem populations, mammographic screening of women older than 65 can be expected to yield a 40% reduction in breast-cancer mortality after 10 years.

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    Article: Tailored messages, external barriers, and women's utilization of professional breast cancer screening over time
    R.N. Diane Ruth Lauver Ph.D, R.N. Lori Settersten Ph.D, Janet H. Kane Ph.D, Jeffrey B. Henriques Ph.D, Diane Ruth Lauver, Lori Settersten, Janet H. Kane, Jeffrey B. Henriques
    [show abstract] [hide abstract]
    ABSTRACT: BACKGROUND The efficacy of tailored messages on women's utilization of professional breast screening over time has not been examined often or in combination with external barriers (e.g., costs and access). The objectives of this study were to test the effects of alternative messages on mammography and clinical breast examination (CBE) utilization over time and to examine the combined effects of such messages and external barriers.METHODS In a randomized, controlled trial, three message conditions were compared: no message (control group), recommendations about screening, or recommendations plus tailored discussion (on beliefs, feelings, costs, and access). Messages were delivered by advanced practice nurses over the telephone. Participants were women ages 51–80 years who had not had mammography in the prior 13 months. Outcome measures were women's mammography and CBE utilization 3–6 months postintervention (short-term follow-up) and 13–16 months after short-term follow-up (long-term follow-up).RESULTSBoth messages promoted mammography and CBE utilization at short-term follow-up. Utilization increased over time in all groups. Mammography utilization was greater for the tailored-message group compared with the recommendations-only group at long-term follow-up. Messages and external barriers had combined effects (Ps < 0.01). Among participants with high external barriers, participants in the message conditions—especially the tailored message—had the highest screening rates; among participants with low barriers, screening rates were similar across conditions.CONCLUSIONS Clinicians can tailor discussions on beliefs, feelings, cost, and access about screening to promote professional breast screening over time, especially with women who have not had mammograms as recommended and who have external barriers to screening. Cancer 2003;97:2724–35. © 2003 American Cancer Society.DOI 10.1002/cncr.11397
    Cancer 05/2003; 97(11):2724 - 2735. · 4.77 Impact Factor
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    Article: Evaluation of service screening mammography in practice: the impact on breast cancer mortality.
    R Gabe, S W Duffy
    Annals of Oncology 02/2005; 16 Suppl 2:ii153-62. · 6.43 Impact Factor
  • Source
    Article: Tailored messages, external barriers, and women's utilization of professional breast cancer screening over time.
    Diane Ruth Lauver, Lori Settersten, Janet H Kane, Jeffrey B Henriques
    [show abstract] [hide abstract]
    ABSTRACT: The efficacy of tailored messages on women's utilization of professional breast screening over time has not been examined often or in combination with external barriers (e.g., costs and access). The objectives of this study were to test the effects of alternative messages on mammography and clinical breast examination (CBE) utilization over time and to examine the combined effects of such messages and external barriers. In a randomized, controlled trial, three message conditions were compared: no message (control group), recommendations about screening, or recommendations plus tailored discussion (on beliefs, feelings, costs, and access). Messages were delivered by advanced practice nurses over the telephone. Participants were women ages 51-80 years who had not had mammography in the prior 13 months. Outcome measures were women's mammography and CBE utilization 3-6 months postintervention (short-term follow-up) and 13-16 months after short-term follow-up (long-term follow-up). Both messages promoted mammography and CBE utilization at short-term follow-up. Utilization increased over time in all groups. Mammography utilization was greater for the tailored-message group compared with the recommendations-only group at long-term follow-up. Messages and external barriers had combined effects (Ps < 0.01). Among participants with high external barriers, participants in the message conditions-especially the tailored message-had the highest screening rates; among participants with low barriers, screening rates were similar across conditions. Clinicians can tailor discussions on beliefs, feelings, cost, and access about screening to promote professional breast screening over time, especially with women who have not had mammograms as recommended and who have external barriers to screening.
    Cancer 06/2003; 97(11):2724-35. · 4.77 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

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Keywords

31 December
 
40 Nijmegen patients
 
40% reduction
 
51 Arnhem patients
 
95% confidence intervals
 
breast cancer
 
breast-cancer mortality
 
breast-cancer mortality rate
 
cumulative mortality-rate ratio
 
entry date
 
incidence rate
 
mammographic screening
 
mammographic screening programme
 
mass screening
 
mortality rate ratios
 
neighbouring city
 
Nijmegen breast-screening programme
 
primary breast cancer
 
Recent case-referent studies
 
study period
 

J A van Dijck