Breast cancer in Switzerland: a comparison between organized-screening versus opportunistic-screening cantons.

breast cancer breast cancer screening cancer stage

Journal

ESMO open
ISSN: 2059-7029
Titre abrégé: ESMO Open
Pays: England
ID NLM: 101690685

Informations de publication

Date de publication:
24 Sep 2024
Historique:
received: 07 04 2024
revised: 28 07 2024
accepted: 03 08 2024
medline: 26 9 2024
pubmed: 26 9 2024
entrez: 25 9 2024
Statut: aheadofprint

Résumé

Switzerland is one of the few remaining European countries without a uniform national breast cancer screening program. Most Swiss cantons have initiated mammography screening programs, with the notable exceptions of the cantons of central Switzerland. The aim of this study is to compare the TNM (tumor-node-metastasis) status in woman diagnosed with screen- and non-screen-detected breast cancers. We compare TNM of breast cancers of cantonal screening cantons (Or-SC) with organized mammographic screening and opportunistic-screening cantons (Op-SC) without organized mammographic screening. We compared the TNM documented in cantons with organized screening (Or-SC) in the national cancer registry with those in the cantons of central Switzerland without organized screening (Op-SC) between 2014 and 2020. Since 2014, a total of 19 236 patients from Or-SC and 2282 from Op-SC with breast cancer were compared. Age groups were defined as younger than 50 years, between 50 and 69 years, and older than 70 years. By comparison, women aged 50-69 years in the cantons of the Op-SC group exhibited significantly larger tumors T1-3 [point estimate of the difference with 95% confidence interval (CI) for T1: -7.7% (95% CI -11.0% to -4.4%); T2: 5.3% (95% CI 2.2% to 8.5%); T3: 2.5% (95% CI 0.8% to 4.2%)] and significantly fewer proportion of N0 [-5.7% (95% CI -9.0% to -2.5%)] without significant difference in the M status (P = 0.97). Our study shows that patients aged 50-69 years from Op-SC have significantly larger tumors and higher incidence of lymph node metastases than women in the corresponding Or-SC group. This globally unique case within one single small country with very high living standards, but with different screening strategies, indicates the benefits of organized breast screening programs.

Sections du résumé

BACKGROUND BACKGROUND
Switzerland is one of the few remaining European countries without a uniform national breast cancer screening program. Most Swiss cantons have initiated mammography screening programs, with the notable exceptions of the cantons of central Switzerland. The aim of this study is to compare the TNM (tumor-node-metastasis) status in woman diagnosed with screen- and non-screen-detected breast cancers. We compare TNM of breast cancers of cantonal screening cantons (Or-SC) with organized mammographic screening and opportunistic-screening cantons (Op-SC) without organized mammographic screening.
MATERIALS AND METHODS METHODS
We compared the TNM documented in cantons with organized screening (Or-SC) in the national cancer registry with those in the cantons of central Switzerland without organized screening (Op-SC) between 2014 and 2020. Since 2014, a total of 19 236 patients from Or-SC and 2282 from Op-SC with breast cancer were compared. Age groups were defined as younger than 50 years, between 50 and 69 years, and older than 70 years.
RESULTS RESULTS
By comparison, women aged 50-69 years in the cantons of the Op-SC group exhibited significantly larger tumors T1-3 [point estimate of the difference with 95% confidence interval (CI) for T1: -7.7% (95% CI -11.0% to -4.4%); T2: 5.3% (95% CI 2.2% to 8.5%); T3: 2.5% (95% CI 0.8% to 4.2%)] and significantly fewer proportion of N0 [-5.7% (95% CI -9.0% to -2.5%)] without significant difference in the M status (P = 0.97).
CONCLUSION CONCLUSIONS
Our study shows that patients aged 50-69 years from Op-SC have significantly larger tumors and higher incidence of lymph node metastases than women in the corresponding Or-SC group. This globally unique case within one single small country with very high living standards, but with different screening strategies, indicates the benefits of organized breast screening programs.

Identifiants

DOI: 10.1016/j.esmoop.2024.103712 PMID: 39321720
pubmed: 39321720
pii: S2059-7029(24)01482-0
doi: 10.1016/j.esmoop.2024.103712
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

103712

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Auteurs

A Gutzeit (A)

Department of Radiology and Nuclear Medicine, Cantonal hospital Schaffhausen, Schaffhausen; University of Lucerne, Department of Health Sciences and Medicine, Lucerne. Electronic address: andreas.gutzeit@spitaeler-sh.ch.

P Dubsky (P)

University of Lucerne, Department of Health Sciences and Medicine, Lucerne; St. Anna Breast Center, Hirslanden Klinik St. Anna, Lucerne, Lucerne, Switzerland.

S Matoori (S)

Department of Radiology and Nuclear Medicine, Cantonal hospital Schaffhausen, Schaffhausen; Faculté de Pharmacie, Université de Montréal, Pavillon Jean-Coutu, Montréal, Canada.

T Plümecke (T)

University of Freiburg, Institute of Sociology, Freiburg, Germany.

J M Froehlich (JM)

Department of Radiology and Nuclear Medicine, Cantonal hospital Schaffhausen, Schaffhausen; University of Lucerne, Department of Health Sciences and Medicine, Lucerne.

R Bech-Hohenberger (R)

Department of Radiology and Nuclear Medicine, Cantonal hospital Schaffhausen, Schaffhausen.

S Bucher (S)

Breast Center, Lucerne Cantonal Hospital, Lucerne Switzerland.

A Günthert (A)

University of Lucerne, Department of Health Sciences and Medicine, Lucerne.

B Grüber-Hoffmann (B)

Department of Radiology and Nuclear Medicine, Cantonal hospital Schaffhausen, Schaffhausen.

D M Koh (DM)

Department of Radiology, Royal Marsden Hospital, Sutton, Surrey, UK.

J Diebold (J)

Institute of Pathology, Cantonal Hospital Lucerne; Cancer Registry of Central Switzerland, Lucerne, Switzerland.

Classifications MeSH