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Duffy SW, Tabár L, Yen AMF, Dean PB, Smith RA, Jonsson H, Törnberg S, Chiu SYH, Chen SLS, Jen GHH, Ku MMS, Hsu CY, Ahlgren J, Maroni R, Holmberg L, Chen THH. Beneficial Effect of Consecutive Screening Mammography Examinations on Mortality from Breast Cancer: A Prospective Study. Radiology 2021; 299:541-547. [PMID: 33650900 DOI: 10.1148/radiol.2021203935] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Previously, the risk of death from breast cancer was analyzed for women participating versus those not participating in the last screening examination before breast cancer diagnosis. Consecutive attendance patterns may further refine estimates. Purpose To estimate the effect of participation in successive mammographic screening examinations on breast cancer mortality. Materials and Methods Participation data for Swedish women eligible for screening mammography in nine counties from 1992 to 2016 were linked with data from registries and regional cancer centers for breast cancer diagnosis, cause, and date of death (Uppsala University ethics committee registration number: 2017/147). Incidence-based breast cancer mortality was calculated by whether the women had participated in the most recent screening examination prior to diagnosis only (intermittent participants), the penultimate screening examination only (lapsed participants), both examinations (serial participants), or neither examination (serial nonparticipants). Rates were analyzed with Poisson regression. We also analyzed incidence of breast cancers proving fatal within 10 years. Results Data were available for a total average population of 549 091 women (average age, 58.9 years ± 6.7 [standard deviation]). The numbers of participants in the four groups were as follows: serial participants, 392 135; intermittent participants, 41 746; lapsed participants, 30 945; and serial nonparticipants, 84 265. Serial participants had a 49% lower risk of breast cancer mortality (relative risk [RR], 0.51; 95% CI: 0.48, 0.55; P < .001) and a 50% lower risk of death from breast cancer within 10 years of diagnosis (RR, 0.50; 95% CI: 0.46, 0.55; P < .001) than serial nonparticipants. Lapsed and intermittent participants had a smaller reduction. Serial participants had significantly lower risk of both outcomes than lapsed or intermittent participants. Analyses correcting for potential biases made little difference to the results. Conclusion Women participating in the last two breast cancer screening examinations prior to breast cancer diagnosis had the largest reduction in breast cancer death. Missing either one of the last two examinations conferred a significantly higher risk. Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Stephen A. Feig in this issue.
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Affiliation(s)
- Stephen W Duffy
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - László Tabár
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Amy Ming-Fang Yen
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Peter B Dean
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Robert A Smith
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Håkan Jonsson
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Sven Törnberg
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Sherry Yueh-Hsia Chiu
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Sam Li-Sheng Chen
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Grace Hsiao-Hsuan Jen
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - May Mei-Sheng Ku
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Chen-Yang Hsu
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Johan Ahlgren
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Roberta Maroni
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Lars Holmberg
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
| | - Tony Hsiu-Hsi Chen
- From the Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, England (S.W.D., R.M.); Department of Mammography, Falun Central Hospital, Falun, Sweden (L.T.); School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan (A.M.F.Y., S.L.S.C.); Department of Diagnostic Radiology, University of Turku, Turku, Finland (P.B.D.); Department of Cancer Control Sciences, American Cancer Society, Atlanta, Ga (R.A.S.); Regional Cancer Center, Umeå University, Umeå, Sweden (H.J.); Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden (S.T.); Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan (S.Y.H.C.); Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (S.Y.H.C.); Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan (S.Y.H.C., G.H.H.J., M.M.S.K., C.Y.H., T.H.H.C.); Regional Cancer Center, Uppsala University Hospital, Uppsala, Sweden (J.A.); Translational Oncology & Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, England (L.H.); and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (L.H.)
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