Non-Participation in Breast Cancer Screening in Spain and Potential Application in the Present and Future: A Cross Sectional Study

Comparison of the differential effect of participation in breast cancer screening program versus opportunistic screening or symptomatic detection on tumour characteristics

OBJECTIVES

The success of a breast cancer screening program is highly dependent on adherence. We aimed to compare the differential effect of participation in breast cancer screening program versus opportunistic screening or symptomatic detection on tumour characteristics.

METHODS

We included women referred to our Breast Centre in 2015-2021: 321 from the breast cancer screening group (group 1) and 422 through opportunistic screening or due to symptomatic detection (group 2). We compared data on sociodemographics, breast cancer detection, clinical features and tumour characteristics.

RESULTS

A total of 10.6% of women in group 1 had breast symptoms and 63.8% had breast signs, with group 2 presenting higher proportions (57.6 and 77.8%, respectively, P < 0.001). The median tumour size in group 1 was smaller compared with group 2 (14 vs 17 mm, P < 0.001). A total of 8.7% of women in group 1 had nodal involvement whereas in group 2 the proportion corresponded to 19.0% (P < 0.001). No women in group 1 were diagnosed with metastasis, while metastases were found in 2.4% of those from group 2 (P = 0.005). There were no significant differences in molecular subtype of invasive tumours between the two groups.

CONCLUSION

The tumour characteristics of women who participated in the breast cancer screening program showed in almost all characteristics more favourable results in comparison with the group who underwent opportunistic screening or sought care due to symptoms. The lower clinical stage observed in those referred from the organised program reaffirms that it is an effective measure for early detection, diagnosis, and treatment.

Two-Year-Span Breast Cancer Screening Uptake in Japan after the COVID-19 Pandemic and Its Association with the COVID-19 Vaccination

There is limited information on whether the COVID-19 pandemic was associated with decreased breast cancer screening uptake and if COVID-19 vaccination was associated with an increase in screening uptake. Our study explored the uptake of breast cancer screening in Japan after the COVID-19 pandemic and assessed its association with the COVID-19 vaccination. We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), a web-based prospective cohort survey, and we included 6110 women without cancer history who were aged 40 to 74 years that participated in the 2012 and 2022 surveys. We examined the regular breast cancer screening uptake before and after the pandemic and employed a multivariable Poisson regression model to seek any association between COVID-19 vaccination and screening uptake. Of 6110, 38.2% regularly participated in screening before the pandemic and 46.9% did so after the pandemic. Individuals unvaccinated due to health reasons (incidence rate ratio (IRR) = 0.47, 95% CI: 0.29-0.77, p = 0.003) and for other reasons (IRR = 0.73, 95% CI: 0.62-0.86, p < 0.001) were less likely to undergo screening compared to fully vaccinated individuals. There was no long-term decrease in breast cancer screening uptake after the pandemic in Japan. Vaccination was linked to increased uptake, but there was no dose relationship.

Breast cancer screening and its associating factors among hungarian women aged 45-65: a cross-sectional study based on the European health interview surveys from 2009 to 2019

BACKGROUND

In 2020, globally 685,000 people died, and 2.3 million women were diagnosed with breast cancer. The main cause of cancer deaths among women is breast cancer, which account for 15.5% of all cancer deaths. Most of these could have been avoided with timely diagnosis. The aim of our study was to determine the proportion of breast screening participation in Hungary, and to identify possible factors that may influence breast screening attendance.

METHODS

Our data were gathered from the cross-sectional European Health Interview Surveys conducted in Hungary in 2009, 2014, and 2019. In terms of categorical characteristics, Pearson's chi-square test was performed to evaluate the differences between people who have attended breast screening within two years and who have only attended more than two years ago. To determine the factors that may have an impact on the uptake of screening, generalized linear model with logit link function regarding binomial probability distribution was executed.

RESULTS

The responses of 2626 women between the age 45-65 were included in our study. In 2009 85% (n=741), in 2014 90% (n=851) and in 2019 87% (n=699) of the respondents claimed to have ever attended a breast screening in their life. In 2009 68% (n=594), in 2014 66% (n=630) and in 2019 64% (n=515) said that they have taken part in breast screening within two years (p=0.331). From 2014 to 2019 (AOR=0.72 [0.57-0.89]) the chance of attending breast screening was decreasing. We observed that both secondary (AOR=1.97 [1.60-2.44]) and tertiary educational level (AOR=2.23 [1.67-3.00]), higher perceived income (AOR=1.54 [1.25-1.90]), and more frequent meeting with the doctor (AOR=1.77 [1.39-2.27]) and with the specialist (AOR=1.88 [1.54-2.28]) appeared as protective factors of breast screening attendance.

CONCLUSIONS

Our results show that the lifetime prevalence of breast screening participation is high, however the recommended biennial rate is relatively low. To increase the participation rate, various initiatives would be needed, especially for women in identified risk groups, which are lower educational level, lower perceived income, and less frequent meeting with the doctor and with the specialist.

Diagnostic delay of oral squamous cell carcinoma and the fear of diagnosis: A scoping review

The mortality rate of patients affected with oral squamous cell carcinoma (OSCC) has been stable in recent decades due to several factors, especially diagnostic delay, which is often associated with a late stage diagnosis and poor prognosis. The aims of this paper were to: analyze diagnostic delay in OSCC and to discuss the various psychological factors of patients with OSCC, with particular attention to the patient's fear of receiving news regarding their health; and the professional dynamics related to the decision-making processes in cases of suspected OSCC. A preliminary review of literature focusing on OSCC diagnostic delay was performed. Seven articles were included with the diagnostic delay ranging from 45  days to approximately 6  months. Patients' fears and, to a lesser degree, the concerns of dentists, were found to be still poorly investigated. On the basis of the authors' professional experience, the development of oral lesions of unknown origin may generate different behaviors in the decision-making processes by patients and clinicians, and fear may play a key role in the distinct steps of this process. It is crucial to increase awareness and inform patients about the onset of OSCC, and contemporaneously encourage experimental studies on patients' fear and professional behaviors with respect to communication regarding OSCC.