University of British Columbia School of Population and Public Health, North Vancouver, BC, Canada
Joseph Ragaz , Joel Fox , Shayan Shakeraneh , Kenneth S. Wilson , Hong Qian , Hubert Wong
Background: To correlate age-standardized rates [ASRs] of DCIS, BrCaINV and BrCaMOR, separately for ages <50 vs >50. British Columbia [BC] is known for earlier introduction, tighter adherence to, and more uniformity of ScreenMam than the Atlantic Provinces [AP]. Methods: Annual age-specific rates [ASRs] of DCIS, BrCaINV, and BrCaMOR were obtained for 17 five-year age groups (years 0-4 to 85+) in BC and AP, and averaged over 5-year1970-1974 to 2005-2009 periods [Lustrum], separately for ages <50 and >50. BrCaINV and BrCaMOR rates were expressed in percentages, relative to 1970-74 average. Data were obtained from Canada Public Health Agency and Canada Ca Registry database at Statistics Canada. Results: See Tables. Conclusions: DCIS: Rates are substantially increased since 1970s in both regions. For ages >50, rate stabilization is seen after 2000s, particularly in BC where the rate decrease is seen after 2005. BrCaINV: In both regions, rates for ages <50 have been stable. For ages >50, rates are initially increasing and then decreasing, with reduction observed to a lower extent in BC, and much earlier than in AP BrCaMOR: For both age groups, rate decrease is more substantial in BC than AP. Difference is particularly evident for ages >50, with reduction in BC observed at least a decade earlier, and to a much lower degree. SUMMARY: Levelling or decrease of DCIS rates in regions with more adherent ScreenMam is a new observation which may antedate a more substantial delayed rate reduction of both BrCaINV and BrCaMOR. Earlier diagnosis & therapy of less resistant BrCa lesions, as enabled by ScreenMam, are the likely causes for these outcome improvements.
DCIS | BrCaINV [%] | BrCaMOR [%] | ||||
---|---|---|---|---|---|---|
Lustrum | BC | AP | BC | AP | BC | AP |
1980-84 | 1.7 | 0.9 | 91 | 96 | 89 | 90 |
1985-89 | 3.3 | 1.4 | 95 | 99 | 88 | 94 |
1990-94 | 3.8 | 2.5 | 95 | 104 | 82 | 86 |
1995-99 | 4.5 | 2.9 | 89 | 109 | 71 | 80 |
2000-04 | 4.9 | 3.4 | 87 | 101 | 53 | 63 |
2005-09 | 5.4 | 3.6 | 90 | 103 | 49 | 53 |
DCIS | BrCaINV [%] | BrCaMOR [%] | ||||
---|---|---|---|---|---|---|
Lustrum | BC | AP | BC | AP | BC | AP |
1980-84 | 11.1 | 6.8 | 103 | 109 | 100 | 108 |
1985-89 | 23.0 | 9.9 | 119 | 126 | 101 | 103 |
1990-94 | 32.2 | 19.7 | 124 | 142 | 95 | 118 |
1995-99 | 45.2 | 31.8 | 121 | 149 | 86 | 113 |
2000-04 | 46.4 | 38.1 | 107 | 142 | 71 | 94 |
2005-09 | 44.9 | 40.0 | 106 | 138 | 64 | 78 |
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