Breast cancer risk and population-based cancer screening programmes.

Breast cancer is an important health problem, globally it is one of the cancers with the highest mortality and it is the leading cause of cancer death in females in many Western countries. In the European Union alone, the estimated incidence and mortality for breast cancer in 2012 was 358,967 cases of breast cancer and 90,665 deaths attributable to breast cancer. Mammographic Breast Cancer Screening (MBCS) is the only breast cancer screening test with a proven capacity to reduce breast cancer mortality. However, MBCS is not perfect: besides the advantage on mortality it also has disadvantages such as overdiagnosis (and incurring overtreatment) and false-positive recall. Flanders has an organised government sponsored MBCS programme. This PhD was written to answers questions brought forward in discussions with experts working in the MBCS programme. In the first paper, we addressed the need for accurate cancer risk estimates appropriate for inclusion in informed decision making. In the second paper, we investigated the reasons for drop-out by quantifying independent risk factors for failing to rescreen and built a model to predict how rescreening rates change if these risk factors would be modified. In the third paper, we showed that the women who are most likely to drop out, those with a false-positive screening result, are also women who are at an increased risk for breast cancer

Publication year:2017

Keywords:Breast cancer