Variation in detection of ductal carcinoma in situ during screening mammography: a survey within the International Cancer Screening Network

Elsebeth Lynge; Antonio Ponti; Ted James; Ondřej Májek; My von Euler-Chelpin; Ahti Anttila; Patricia Fitzpatrick; Alfonso Frigerio; Masaaki Kawai; Astrid Scharpantgen; Mireille Broeders; Solveig Hofvind; Carmen Vidal; Maria Ederra; Dolores Salas; Jean-Luc Bulliard; Mariano Tomatis; Karla Kerlikowske; Stephen Taplin; ICSN DCIS Working group

doi:10.1016/j.ejca.2013.08.013

Variation in detection of ductal carcinoma in situ during screening mammography: a survey within the International Cancer Screening Network

Elsebeth Lynge, Antonio Ponti, Ted James, Ondřej Májek, My von Euler-Chelpin, Ahti Anttila, Patricia Fitzpatrick, Alfonso Frigerio, Masaaki Kawai, Astrid Scharpantgen, Mireille Broeders, Solveig Hofvind, Carmen Vidal, Maria Ederra, Dolores Salas, Jean-Luc Bulliard, Mariano Tomatis, Karla Kerlikowske, Stephen Taplin, ICSN DCIS Working group

39 Citations (Scopus)

Abstract

BACKGROUND: There is concern about detection of ductal carcinoma in situ (DCIS) in screening mammography. DCIS accounts for a substantial proportion of screen-detected lesions but its effect on breast cancer mortality is debated. The International Cancer Screening Network conducted a comparative analysis to determine variation in DCIS detection.

PATIENTS AND METHODS: Data were collected during 2004-2008 on number of screening examinations, detected breast cancers, DCIS cases and Globocan 2008 breast cancer incidence rates derived from national or regional cancer registers. We calculated screen-detection rates for breast cancers and DCIS.

RESULTS: Data were obtained from 15 screening settings in 12 countries; 7,176,050 screening examinations; 29,605 breast cancers and 5324 DCIS cases. The ratio between highest and lowest breast cancer incidence was 2.88 (95% confidence interval (CI) 2.76-3.00); 2.97 (95% CI 2.51-3.51) for detection of breast cancer; and 3.49 (95% CI 2.70-4.51) for detection of DCIS.

CONCLUSIONS: Considerable international variation was found in DCIS detection. This variation could not be fully explained by variation in incidence nor in breast cancer detection rates. It suggests the potential for wide discrepancies in management of DCIS resulting in overtreatment of indolent DCIS or undertreatment of potentially curable disease. Comprehensive cancer registration is needed to monitor DCIS detection. Efforts to understand discrepancies and standardise management may improve care.

Original language	English
Journal	European journal of cancer (Oxford, England : 1990)
Volume	50
Issue number	1
Pages (from-to)	185-92
Number of pages	8
ISSN	0959-8049
DOIs	https://doi.org/10.1016/j.ejca.2013.08.013
Publication status	Published - Jan 2014

Keywords

Aged
Breast Neoplasms
Carcinoma, Ductal, Breast
Carcinoma, Intraductal, Noninfiltrating
Data Collection
Early Detection of Cancer
Europe
Female
Humans
Mammography
Middle Aged
United States

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ejca.2013.08.013

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Lynge, E., Ponti, A., James, T., Májek, O., von Euler-Chelpin, M., Anttila, A., Fitzpatrick, P., Frigerio, A., Kawai, M., Scharpantgen, A., Broeders, M., Hofvind, S., Vidal, C., Ederra, M., Salas, D., Bulliard, J.-L., Tomatis, M., Kerlikowske, K., Taplin, S., & ICSN DCIS Working group (2014). Variation in detection of ductal carcinoma in situ during screening mammography: a survey within the International Cancer Screening Network. European journal of cancer (Oxford, England : 1990), 50(1), 185-92. https://doi.org/10.1016/j.ejca.2013.08.013

Variation in detection of ductal carcinoma in situ during screening mammography: a survey within the International Cancer Screening Network. / Lynge, Elsebeth; Ponti, Antonio; James, Ted et al.
In: European journal of cancer (Oxford, England : 1990), Vol. 50, No. 1, 01.2014, p. 185-92.

Research output: Contribution to journal › Journal article › Research › peer-review

Lynge, E, Ponti, A, James, T, Májek, O, von Euler-Chelpin, M, Anttila, A, Fitzpatrick, P, Frigerio, A, Kawai, M, Scharpantgen, A, Broeders, M, Hofvind, S, Vidal, C, Ederra, M, Salas, D, Bulliard, J-L, Tomatis, M, Kerlikowske, K, Taplin, S & ICSN DCIS Working group 2014, 'Variation in detection of ductal carcinoma in situ during screening mammography: a survey within the International Cancer Screening Network', European journal of cancer (Oxford, England : 1990), vol. 50, no. 1, pp. 185-92. https://doi.org/10.1016/j.ejca.2013.08.013

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title = "Variation in detection of ductal carcinoma in situ during screening mammography: a survey within the International Cancer Screening Network",

abstract = "BACKGROUND: There is concern about detection of ductal carcinoma in situ (DCIS) in screening mammography. DCIS accounts for a substantial proportion of screen-detected lesions but its effect on breast cancer mortality is debated. The International Cancer Screening Network conducted a comparative analysis to determine variation in DCIS detection.PATIENTS AND METHODS: Data were collected during 2004-2008 on number of screening examinations, detected breast cancers, DCIS cases and Globocan 2008 breast cancer incidence rates derived from national or regional cancer registers. We calculated screen-detection rates for breast cancers and DCIS.RESULTS: Data were obtained from 15 screening settings in 12 countries; 7,176,050 screening examinations; 29,605 breast cancers and 5324 DCIS cases. The ratio between highest and lowest breast cancer incidence was 2.88 (95% confidence interval (CI) 2.76-3.00); 2.97 (95% CI 2.51-3.51) for detection of breast cancer; and 3.49 (95% CI 2.70-4.51) for detection of DCIS.CONCLUSIONS: Considerable international variation was found in DCIS detection. This variation could not be fully explained by variation in incidence nor in breast cancer detection rates. It suggests the potential for wide discrepancies in management of DCIS resulting in overtreatment of indolent DCIS or undertreatment of potentially curable disease. Comprehensive cancer registration is needed to monitor DCIS detection. Efforts to understand discrepancies and standardise management may improve care.",

keywords = "Aged, Breast Neoplasms, Carcinoma, Ductal, Breast, Carcinoma, Intraductal, Noninfiltrating, Data Collection, Early Detection of Cancer, Europe, Female, Humans, Mammography, Middle Aged, United States",

author = "Elsebeth Lynge and Antonio Ponti and Ted James and Ond{\v r}ej M{\'a}jek and {von Euler-Chelpin}, My and Ahti Anttila and Patricia Fitzpatrick and Alfonso Frigerio and Masaaki Kawai and Astrid Scharpantgen and Mireille Broeders and Solveig Hofvind and Carmen Vidal and Maria Ederra and Dolores Salas and Jean-Luc Bulliard and Mariano Tomatis and Karla Kerlikowske and Stephen Taplin and {ICSN DCIS Working group}",

year = "2014",

month = jan,

doi = "10.1016/j.ejca.2013.08.013",

language = "English",

volume = "50",

pages = "185--92",

journal = "European journal of cancer (Oxford, England : 1990)",

issn = "0959-8049",

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TY - JOUR

T1 - Variation in detection of ductal carcinoma in situ during screening mammography

T2 - a survey within the International Cancer Screening Network

AU - Lynge, Elsebeth

AU - Ponti, Antonio

AU - James, Ted

AU - Májek, Ondřej

AU - von Euler-Chelpin, My

AU - Anttila, Ahti

AU - Fitzpatrick, Patricia

AU - Frigerio, Alfonso

AU - Kawai, Masaaki

AU - Scharpantgen, Astrid

AU - Broeders, Mireille

AU - Hofvind, Solveig

AU - Vidal, Carmen

AU - Ederra, Maria

AU - Salas, Dolores

AU - Bulliard, Jean-Luc

AU - Tomatis, Mariano

AU - Kerlikowske, Karla

AU - Taplin, Stephen

AU - ICSN DCIS Working group

PY - 2014/1

Y1 - 2014/1

N2 - BACKGROUND: There is concern about detection of ductal carcinoma in situ (DCIS) in screening mammography. DCIS accounts for a substantial proportion of screen-detected lesions but its effect on breast cancer mortality is debated. The International Cancer Screening Network conducted a comparative analysis to determine variation in DCIS detection.PATIENTS AND METHODS: Data were collected during 2004-2008 on number of screening examinations, detected breast cancers, DCIS cases and Globocan 2008 breast cancer incidence rates derived from national or regional cancer registers. We calculated screen-detection rates for breast cancers and DCIS.RESULTS: Data were obtained from 15 screening settings in 12 countries; 7,176,050 screening examinations; 29,605 breast cancers and 5324 DCIS cases. The ratio between highest and lowest breast cancer incidence was 2.88 (95% confidence interval (CI) 2.76-3.00); 2.97 (95% CI 2.51-3.51) for detection of breast cancer; and 3.49 (95% CI 2.70-4.51) for detection of DCIS.CONCLUSIONS: Considerable international variation was found in DCIS detection. This variation could not be fully explained by variation in incidence nor in breast cancer detection rates. It suggests the potential for wide discrepancies in management of DCIS resulting in overtreatment of indolent DCIS or undertreatment of potentially curable disease. Comprehensive cancer registration is needed to monitor DCIS detection. Efforts to understand discrepancies and standardise management may improve care.

AB - BACKGROUND: There is concern about detection of ductal carcinoma in situ (DCIS) in screening mammography. DCIS accounts for a substantial proportion of screen-detected lesions but its effect on breast cancer mortality is debated. The International Cancer Screening Network conducted a comparative analysis to determine variation in DCIS detection.PATIENTS AND METHODS: Data were collected during 2004-2008 on number of screening examinations, detected breast cancers, DCIS cases and Globocan 2008 breast cancer incidence rates derived from national or regional cancer registers. We calculated screen-detection rates for breast cancers and DCIS.RESULTS: Data were obtained from 15 screening settings in 12 countries; 7,176,050 screening examinations; 29,605 breast cancers and 5324 DCIS cases. The ratio between highest and lowest breast cancer incidence was 2.88 (95% confidence interval (CI) 2.76-3.00); 2.97 (95% CI 2.51-3.51) for detection of breast cancer; and 3.49 (95% CI 2.70-4.51) for detection of DCIS.CONCLUSIONS: Considerable international variation was found in DCIS detection. This variation could not be fully explained by variation in incidence nor in breast cancer detection rates. It suggests the potential for wide discrepancies in management of DCIS resulting in overtreatment of indolent DCIS or undertreatment of potentially curable disease. Comprehensive cancer registration is needed to monitor DCIS detection. Efforts to understand discrepancies and standardise management may improve care.

KW - Aged

KW - Breast Neoplasms

KW - Carcinoma, Ductal, Breast

KW - Carcinoma, Intraductal, Noninfiltrating

KW - Data Collection

KW - Early Detection of Cancer

KW - Europe

KW - Female

KW - Humans

KW - Mammography

KW - Middle Aged

KW - United States

U2 - 10.1016/j.ejca.2013.08.013

DO - 10.1016/j.ejca.2013.08.013

M3 - Journal article

C2 - 24041876

SN - 0959-8049

VL - 50

SP - 185

EP - 192

JO - European journal of cancer (Oxford, England : 1990)

JF - European journal of cancer (Oxford, England : 1990)

IS - 1

ER -

Variation in detection of ductal carcinoma in situ during screening mammography: a survey within the International Cancer Screening Network

Abstract

Keywords

UN SDGs

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