Clinical Edge

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Breast Cancer Screening and Mortality

Do results vary at the county level?

There was no associated decline in the detection of large cancers among screening mammography rates at the county level along with the absence of any significant difference in the overall rate of death, according to a study of 16 million women aged 40 years and older residing across 547 counties in the U.S. Among these women, 53,207 were diagnosed with breast cancer and followed up for the next 10 years. The study concluded:

• The diagnosis of additional small cancers at the county level

• 16% more breast cancer diagnosis followed an absolute increase of 10 percentage points in the extent of screening but not in death rates.

• An increase of 10 percentage points in screening was associated with a 25% increase in the incidence of breast cancers and a 7% increase in the incidence of larger breast cancers.

Citation: Harding C, Pompei F, Burmistrov D, Welch HG, Abebe R, Wilson R. Breast cancer screening, incidence, and mortality across US counties. JAMA Intern Med. [Published online ahead of print July 6, 2015]. doi: 10.1001/jamainternmed.2015.3043.