Breast cancer prevention in Salzburg: Program shows no significant success!

Breast cancer prevention in Salzburg: Program shows no significant success!

A recent study by Simon Gampenrieder and co-authors on the effectiveness of the Austrian breast cancer screening program in Salzburg shows worrying results. According to the study, which evaluated data from the Salzburg tumor registry from 2010 to 2022, there is no significant reduction in advanced breast cancer compared to previous opportunistic screening. Every year around 5,600 women in Austria develop breast cancer, and around 1,600 women die from it.

The breast cancer screening program was launched in January 2014. The researchers compared the incidence of breast cancer before (2010-2013) and after the implementation of the program (2016-2019). No significant differences were found in the distribution of tumor stages between the two time periods. Although the proportion of stage IV disease decreased from 9.4% to 4.5%, this decrease was not statistically significant.

Analysis of tumor stages

Stage 0 increased from 12.2% to 13.4%, stage I from 44.1% to 46.2%, stage II from 28.2% to 29% and stage III from 6.1% to 6.9%. These changes indicate an increase in earlier tumor stages, but without the expected significant decrease in advanced forms. The age and place of residence of the patients had no significant influence on the tumor stage.

The infection rate in Salzburg fell slightly from 245.7 to 229.8 cases per 100,000 inhabitants - although not statistically significant either. Participation in the screening program remained constant at 45% between 2014 and 2021, indicating that the program has seen limited uptake.

Mammography coverage rate

The mammography coverage rate for women aged 45 to 69 years was 51%, close to the level of the previous opportunistic screening method (55%). It is worrying that there is no evidence of a reduction in breast cancer mortality through the screening program. According to the analysis, improved therapies could contribute to the discrepancy between disease incidence and mortality.

The age limits for the screening program were expanded to 45 to 74 years in 2023, but only around 41% of women in the target group currently use mammography for early detection. In the context of these numbers, a comprehensive analysis conducted in Switzerland shows that out of 1,000 women who participate in an organized screening program, 250 women receive an abnormal mammogram and 65 women are diagnosed with breast cancer. Of the 1,000 women who do not participate in such a program, 55 receive a breast cancer diagnosis.

Overdiagnosis and mortality rates

The evaluation of these programs also shows that 5 to 10 of the diagnoses are overdiagnoses, meaning that they are tumors that would never have caused health problems. As part of the organized program, 16 women die of breast cancer, while in the group without access to the program, 20 women die of the disease. These differences highlight the importance of an organized approach to early detection.

The results of the studies and the statistical data underline the need for a critical review and optimization of breast cancer screening programs in order to both increase effectiveness and reduce corresponding mortality rates. It remains to be seen what measures will be taken to improve the situation.