Does breast cancer screening level health inequalities out? A population-based study in an Italian region
Although population-based screening has the potential to reduce inequalities in breast cancer survival, evidence on this topic is controversial. The objective of this study was to evaluate whether the full implementation of a mammography screening programme in Emilia-Romagna in Italy had an impact o...
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| Veröffentlicht in: | European journal of public health 2014-04, Vol.24 (2), p.280-285 |
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| creator | Pacelli, Barbara Carretta, Elisa Spadea, Teresa Caranci, Nicola Di Felice, Enza Stivanello, Elisa Cavuto, Silvio Cisbani, Luca Candela, Silvia De Palma, Rossana Fantini, Maria P |
| description | Although population-based screening has the potential to reduce inequalities in breast cancer survival, evidence on this topic is controversial. The objective of this study was to evaluate whether the full implementation of a mammography screening programme in Emilia-Romagna in Italy had an impact on variations in breast cancer survival by educational level.
A cohort study was performed, including all women |
| doi_str_mv | 10.1093/eurpub/ckt119 |
| format | Article |
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A cohort study was performed, including all women <70 years and residing in Emilia-Romagna who had infiltrating breast cancer registered in 1997-2000 (transitional screening period) or 2001-03 (consolidation screening period). Cancer cases were retrieved from the regional Breast Cancer Registry and followed up for 5 years. Educational level was determined from census data and allocated to cancer cases by individual record linkage. Age at diagnosis was classified into two groups (30-49, 50-69: screening target population).
A total of 9639 cases were analyzed. In the 1997-2000 period, low-educated women had significantly lower survival compared with high-educated women, both in the younger and in the older age-groups. After the full implementation of the screening programme, these differences decreased in both age-groups, until disappearing completely among women in the age-group invited to screening.
Our findings suggest that a fee-free population-based organized mammography screening programme with active invitation of the whole target population could be effective in reducing differences in survival in the population targeted by the screening.</description><identifier>ISSN: 1101-1262</identifier><identifier>EISSN: 1464-360X</identifier><identifier>DOI: 10.1093/eurpub/ckt119</identifier><identifier>PMID: 24008553</identifier><identifier>CODEN: EJPHF6</identifier><language>eng</language><publisher>England: Oxford Publishing Limited (England)</publisher><subject>Adult ; Aged ; Breast Cancer ; Breast Neoplasms - diagnostic imaging ; Breast Neoplasms - epidemiology ; Cancer ; Census ; Comparative analysis ; Early Detection of Cancer ; Educational Attainment ; Educational Status ; Equality ; Female ; Females ; Humans ; Inequality ; Intervention ; Italy ; Italy - epidemiology ; Mammography ; Mass Screening ; Medical screening ; Middle Aged ; Population ; Registries ; Risk Factors ; Socioeconomic Factors ; Survival Analysis ; Tests ; Women ; Womens health</subject><ispartof>European journal of public health, 2014-04, Vol.24 (2), p.280-285</ispartof><rights>Copyright Oxford Publishing Limited(England) Apr 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-a913a692dd86d0e44d9bc09df397f612078ce90531ee5f245f173cfb3479f9833</citedby><cites>FETCH-LOGICAL-c459t-a913a692dd86d0e44d9bc09df397f612078ce90531ee5f245f173cfb3479f9833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27863,27864,27922,27923,33773</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24008553$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pacelli, Barbara</creatorcontrib><creatorcontrib>Carretta, Elisa</creatorcontrib><creatorcontrib>Spadea, Teresa</creatorcontrib><creatorcontrib>Caranci, Nicola</creatorcontrib><creatorcontrib>Di Felice, Enza</creatorcontrib><creatorcontrib>Stivanello, Elisa</creatorcontrib><creatorcontrib>Cavuto, Silvio</creatorcontrib><creatorcontrib>Cisbani, Luca</creatorcontrib><creatorcontrib>Candela, Silvia</creatorcontrib><creatorcontrib>De Palma, Rossana</creatorcontrib><creatorcontrib>Fantini, Maria P</creatorcontrib><title>Does breast cancer screening level health inequalities out? A population-based study in an Italian region</title><title>European journal of public health</title><addtitle>Eur J Public Health</addtitle><description>Although population-based screening has the potential to reduce inequalities in breast cancer survival, evidence on this topic is controversial. The objective of this study was to evaluate whether the full implementation of a mammography screening programme in Emilia-Romagna in Italy had an impact on variations in breast cancer survival by educational level.
A cohort study was performed, including all women <70 years and residing in Emilia-Romagna who had infiltrating breast cancer registered in 1997-2000 (transitional screening period) or 2001-03 (consolidation screening period). Cancer cases were retrieved from the regional Breast Cancer Registry and followed up for 5 years. Educational level was determined from census data and allocated to cancer cases by individual record linkage. Age at diagnosis was classified into two groups (30-49, 50-69: screening target population).
A total of 9639 cases were analyzed. In the 1997-2000 period, low-educated women had significantly lower survival compared with high-educated women, both in the younger and in the older age-groups. After the full implementation of the screening programme, these differences decreased in both age-groups, until disappearing completely among women in the age-group invited to screening.
Our findings suggest that a fee-free population-based organized mammography screening programme with active invitation of the whole target population could be effective in reducing differences in survival in the population targeted by the screening.</description><subject>Adult</subject><subject>Aged</subject><subject>Breast Cancer</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Cancer</subject><subject>Census</subject><subject>Comparative analysis</subject><subject>Early Detection of Cancer</subject><subject>Educational Attainment</subject><subject>Educational Status</subject><subject>Equality</subject><subject>Female</subject><subject>Females</subject><subject>Humans</subject><subject>Inequality</subject><subject>Intervention</subject><subject>Italy</subject><subject>Italy - epidemiology</subject><subject>Mammography</subject><subject>Mass Screening</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>Population</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Socioeconomic Factors</subject><subject>Survival Analysis</subject><subject>Tests</subject><subject>Women</subject><subject>Womens health</subject><issn>1101-1262</issn><issn>1464-360X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7TQ</sourceid><sourceid>BHHNA</sourceid><recordid>eNqN0rlL7UAUB-BBFPfSVgZsbPKcM1sylYjLe4Jgo2AXJpMTjeYmcZYH_vfO5aqFjVZnim9-cBZCDoD9AWbECSY_p-bEvUQAs0a2QWpZCM0e1vMbGBTANd8iOyE8M8ZUWfFNssUlY5VSYpv0FxMG2ni0IVJnR4eeBucRx358pAP-x4E-oR3iE-1HfE126GOff0wpntIzOk9zGmzsp7FobMCWhpjat0ypHel1zDpXj48Z7JGNzg4B9z_qLrm_urw7_1fc3P69Pj-7KZxUJhbWgLDa8LatdMtQytY0jpm2E6bsNHBWVg4NUwIQVcel6qAUrmuELE1nKiF2yfEqd_bTa8IQ60UfHA6DHXFKoc5caSW5gp-p0iWTQlbmFxR0KfPcq99QyM0A45kefaPPU_JjHs9SCZH7VcvAYqWcn0Lw2NWz7xfWv9XA6uUR1KsjqFdHkP3hR2pqFth-6c-ti3dwqq2g</recordid><startdate>20140401</startdate><enddate>20140401</enddate><creator>Pacelli, Barbara</creator><creator>Carretta, Elisa</creator><creator>Spadea, Teresa</creator><creator>Caranci, Nicola</creator><creator>Di Felice, Enza</creator><creator>Stivanello, Elisa</creator><creator>Cavuto, Silvio</creator><creator>Cisbani, Luca</creator><creator>Candela, Silvia</creator><creator>De Palma, Rossana</creator><creator>Fantini, Maria P</creator><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7TQ</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7ST</scope><scope>7U6</scope><scope>7U4</scope><scope>BHHNA</scope><scope>DWI</scope><scope>WZK</scope></search><sort><creationdate>20140401</creationdate><title>Does breast cancer screening level health inequalities out? A population-based study in an Italian region</title><author>Pacelli, Barbara ; Carretta, Elisa ; Spadea, Teresa ; Caranci, Nicola ; Di Felice, Enza ; Stivanello, Elisa ; Cavuto, Silvio ; Cisbani, Luca ; Candela, Silvia ; De Palma, Rossana ; Fantini, Maria P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-a913a692dd86d0e44d9bc09df397f612078ce90531ee5f245f173cfb3479f9833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Breast Cancer</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Breast Neoplasms - epidemiology</topic><topic>Cancer</topic><topic>Census</topic><topic>Comparative analysis</topic><topic>Early Detection of Cancer</topic><topic>Educational Attainment</topic><topic>Educational Status</topic><topic>Equality</topic><topic>Female</topic><topic>Females</topic><topic>Humans</topic><topic>Inequality</topic><topic>Intervention</topic><topic>Italy</topic><topic>Italy - epidemiology</topic><topic>Mammography</topic><topic>Mass Screening</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>Population</topic><topic>Registries</topic><topic>Risk Factors</topic><topic>Socioeconomic Factors</topic><topic>Survival Analysis</topic><topic>Tests</topic><topic>Women</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pacelli, Barbara</creatorcontrib><creatorcontrib>Carretta, Elisa</creatorcontrib><creatorcontrib>Spadea, Teresa</creatorcontrib><creatorcontrib>Caranci, Nicola</creatorcontrib><creatorcontrib>Di Felice, Enza</creatorcontrib><creatorcontrib>Stivanello, Elisa</creatorcontrib><creatorcontrib>Cavuto, Silvio</creatorcontrib><creatorcontrib>Cisbani, Luca</creatorcontrib><creatorcontrib>Candela, Silvia</creatorcontrib><creatorcontrib>De Palma, Rossana</creatorcontrib><creatorcontrib>Fantini, Maria P</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>PAIS Index</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Environment Abstracts</collection><collection>Sustainability Science Abstracts</collection><collection>Sociological Abstracts (pre-2017)</collection><collection>Sociological Abstracts</collection><collection>Sociological Abstracts</collection><collection>Sociological Abstracts (Ovid)</collection><jtitle>European journal of public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pacelli, Barbara</au><au>Carretta, Elisa</au><au>Spadea, Teresa</au><au>Caranci, Nicola</au><au>Di Felice, Enza</au><au>Stivanello, Elisa</au><au>Cavuto, Silvio</au><au>Cisbani, Luca</au><au>Candela, Silvia</au><au>De Palma, Rossana</au><au>Fantini, Maria P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does breast cancer screening level health inequalities out? A population-based study in an Italian region</atitle><jtitle>European journal of public health</jtitle><addtitle>Eur J Public Health</addtitle><date>2014-04-01</date><risdate>2014</risdate><volume>24</volume><issue>2</issue><spage>280</spage><epage>285</epage><pages>280-285</pages><issn>1101-1262</issn><eissn>1464-360X</eissn><coden>EJPHF6</coden><abstract>Although population-based screening has the potential to reduce inequalities in breast cancer survival, evidence on this topic is controversial. The objective of this study was to evaluate whether the full implementation of a mammography screening programme in Emilia-Romagna in Italy had an impact on variations in breast cancer survival by educational level.
A cohort study was performed, including all women <70 years and residing in Emilia-Romagna who had infiltrating breast cancer registered in 1997-2000 (transitional screening period) or 2001-03 (consolidation screening period). Cancer cases were retrieved from the regional Breast Cancer Registry and followed up for 5 years. Educational level was determined from census data and allocated to cancer cases by individual record linkage. Age at diagnosis was classified into two groups (30-49, 50-69: screening target population).
A total of 9639 cases were analyzed. In the 1997-2000 period, low-educated women had significantly lower survival compared with high-educated women, both in the younger and in the older age-groups. After the full implementation of the screening programme, these differences decreased in both age-groups, until disappearing completely among women in the age-group invited to screening.
Our findings suggest that a fee-free population-based organized mammography screening programme with active invitation of the whole target population could be effective in reducing differences in survival in the population targeted by the screening.</abstract><cop>England</cop><pub>Oxford Publishing Limited (England)</pub><pmid>24008553</pmid><doi>10.1093/eurpub/ckt119</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of public health, 2014-04, Vol.24 (2), p.280-285 |
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| language | eng |
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| source | MEDLINE; PAIS Index; Sociological Abstracts; Oxford Journals Open Access Collection; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Aged Breast Cancer Breast Neoplasms - diagnostic imaging Breast Neoplasms - epidemiology Cancer Census Comparative analysis Early Detection of Cancer Educational Attainment Educational Status Equality Female Females Humans Inequality Intervention Italy Italy - epidemiology Mammography Mass Screening Medical screening Middle Aged Population Registries Risk Factors Socioeconomic Factors Survival Analysis Tests Women Womens health |
| title | Does breast cancer screening level health inequalities out? A population-based study in an Italian region |
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