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Wolfson Institute of Preventive Medicine - Barts and The London

Early breast cancer detection rectifies inequality of breast cancer outcomes

A study of breast cancer outcomes in nine Swedish counties has found that differences among counties in the effect of screening on breast cancer outcomes were mainly due to survival variation in women not participating in screening.

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A doctor examines mammogram as part of a routine breast cancer screening.

An international collaboration of authors, including Professor Stephen Duffy of the Wolfson Institute, examined survival data on 38,278 breast cancers diagnosed and 4312 breast cancer deaths from the Swedish Cancer Register. The results showed that screening conferred similarly high survival rates in the nine counties, indicating that the performance of screening services was similar across counties, and that detection and treatment of breast cancer in early-stage reduces inequalities in breast cancer outcome.

Professor Duffy commented: “In addressing health inequalities, area of residence is a particular focus as it is related to both socioeconomic status and delivery of public health interventions. Our results show that geographic variations in breast cancer outcomes in Sweden were dramatically reduced by breast cancer screening. The drive to reduce socioeconomic and other inequalities in cancer screening participation is worthwhile. Early detection has considerable potential to reduce inequality in cancer outcomes.”


Tabár L, Chen TH, Yen AM, Dean PB, Smith RA, Jonsson H, Törnberg S, Chen SL, Chiu SY, Fann JC, Ku MM, Wu WY, Hsu CY, Chen YC, Svane G, Azavedo E, Grundström H, Sundén P, Leifland K, Frodis E, Ramos J, Epstein B, Åkerlund A, Sundbom A, Bordás P, Wallin H, Starck L, Björkgren A, Carlson S, Fredriksson I, Ahlgren J, Öhman D, Holmberg L, Duffy SW. Early detection of breast cancer rectifies inequality of breast cancer outcomes. J Med Screen. 5 May 2020. doi: 10.1177/0969141320921210.