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

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

A current 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 investigation, which has evaluated data from the Salzburg tumor register from 2010 to 2022, there is no significant reduction in advanced breast cancer compared to the previous opportunistic screening. Every year around 5,600 women fall ill in Austria, with about 1,600 women die of it.

The breast cancer early detection program was introduced in January 2014. The researchers compared the frequency of breast cancer (2010–2013) and after the introduction of the program (2016–2019). No significant differences in the distribution of the tumor stages between the two periods were found. Although the proportion of diseases in stage IV was reduced from 9.4% to 4.5%, this decline was not statistically significant.

analysis of the tumor stages

The stage 0 rose from 12.2% to 13.4%, stage I rose 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 previous tumor stages, but without the hoped -for significant decline in advanced forms. The age and place of residence of the patients had no significant influence on the tumor stage.

The disease rate in Salzburg slightly dropped from 245.7 to 229.8 cases per 100,000 inhabitants - but also not statistically not significant. Participation in the screening program remained constant at 45% between 2014 and 2021, which points out that the program has only found limited acceptance.

mammography supply rate

The mammography supply rate for women between the ages of 45 and 69 was 51%, which roughly corresponds 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 discrepancy between the frequency of disease and mortality.

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

overdiagnoses and mortality figures

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

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