Stage-specific incidence of breast cancer before the beginning of organized screening programs in Italy

Eva Buiatti, Alessandro Barchielli, Simone Bartolacci, Lauro Bucchi, Vincenzo De Lisi, Massimo Federico, Stefano Ferretti, Eugenio Paci, Marcello Vettorazzi, Roberto Zanetti

Research output: Contribution to journalArticlepeer-review


Objective: To measure stage-specific geographic and time variability of breast cancer in seven Italian areas before the onset of organized screening programs. Methods: All invasive cancers (8689 cases) arising in women aged 40-79 years during the pre-screening period 1985-1997, were considered. Multiple Poisson regression analysis was performed. Results: About 39% of the cases were classified as "early," 52% as "advanced," and 9% as "unspecified" stage. Age-adjusted incidence rates showed a significant geographic variation for early but not for advanced cancers (range: 58-103 cases/100,000 and 104-125 cases/100,000, respectively). The result was confirmed in the multiple regression analysis after adjustment for year of diagnosis and age. Early breast cancer risk adjusted for age and registry showed a significant increase over time (+ 3.9% per year for all ages, and + 6.2% per year for age category 50-79). In contrast, a decreasing time trend was observed for advanced cancer of 3 cm or over in women aged less than 60. Conclusions: In our study, early breast cancer incidence varied both by geographic area and time before the commencement of screening. The differences in early-stage incidence may well be related to differences in availability of "spontaneous" mammography. Late-stage incidence decreased over time in younger women and for very advanced cases, but not in the older ones, nor for cancers less than 3 cm. Early detection outside organized screening was only partially efficient in reducing advanced breast cancer incidence. The trend of incidence of advanced disease, as previously proposed, is confirmed to be a valid early indicator of effectiveness of screening.

Original languageEnglish
Pages (from-to)65-71
Number of pages7
JournalCancer Causes and Control
Issue number1
Publication statusPublished - 2002


  • Breast cancer
  • Mammographic screening
  • Stage

ASJC Scopus subject areas

  • Oncology
  • Epidemiology
  • Cancer Research


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