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Lookup NU author(s): Dr Laura WoodsORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2016 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC. We examined survival in screened-detected and non-screen-detected women diagnosed in the West Midlands (UK) and New South Wales (Australia) in order to evaluate whether international differences in survival are related to early diagnosis, or to other factors relating to the healthcare women receive. Data for women aged 50 - 65 years who had been eligible for screening from 50 years were examined. Data for 5,628 women in West Midlands and 6,396 women in New South Wales were linked to screening service records (mean age at diagnosis 53.7 years). We estimated net survival and modelled the excess hazard ratio of breast cancer death by screening status. Survival was lower for women in the West Midlands than in New South Wales (5-year net survival 90.9% [95% CI 89.9%-91.7%] compared with 93.4% [95% CI 92.6%-94.1%], respectively). The difference was greater between the two populations of non-screen-detected women (4.9%) compared to between screen-detected women, (1.8% after adjustment for lead-time and over-diagnosis). The adjusted excess hazard ratio of breast cancer death for West Midlands compared with New South Wales was greater in the non-screen-detected group (EHR 2.00, 95% CI 1.70 - 2.31) but not significantly different to that for women whose cancer had been screen-detected (EHR 1.72, 95% CI 0.87 - 2.56). In this study more than one in three breast cancer deaths in the West Midlands would have been avoided if survival had been the same as in New South Wales. The possibility that women in the UK receive poorer treatment is an important potential explanation which should be examined with care.
Author(s): Woods LM, Rachet B, O'Connell DL, Lawrence G, Coleman MP
Publication type: Article
Publication status: Published
Journal: International Journal of Cancer
Year: 2016
Volume: 138
Issue: 10
Pages: 2404-2414
Print publication date: 15/05/2016
Online publication date: 12/01/2016
Acceptance date: 30/11/2015
Date deposited: 16/05/2022
ISSN (print): 0020-7136
ISSN (electronic): 1097-0215
Publisher: Wiley-Liss Inc.
URL: https://doi.org/10.1002/ijc.29984
DOI: 10.1002/ijc.29984
PubMed id: 26756306
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