Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1999 Nov;81(5):912–917. doi: 10.1038/sj.bjc.6690786

Interval cancers in the Dutch breast cancer screening programme

J Fracheboud 1, H J de Koning 1, P M M Beemsterboer 1, R Boer 1, A L M Verbeek 3, J H C L Hendriks 4, B M van Ineveld 2, M J M Broeders 3, A E de Bruyn 1, P J van der Maas 1
PMCID: PMC2374303  PMID: 10555768

Abstract

The nationwide breast cancer screening programme in The Netherlands for women aged 50–69 started in 1989. In our study we assessed the occurrence and stage distribution of interval cancers in women screened during 1990–1993. Records of 0.84 million screened women were linked to the regional cancer registries yielding a follow-up of at least 2.5 years. Age-adjusted incidence rates and relative (proportionate) incidences per tumour size including ductal carcinoma in-situ were calculated for screen-detected and interval cancers, and cancers in not (yet) screened women, comparing them with published data from the UK regions North West and East Anglia. In total 1527 interval cancers were identified: 0.95 and 0.99 per 1000 woman-years of follow-up in the 2-year interval after initial and subsequent screens respectively. In the first year after initial screening interval cancers amounted to 27% (26% after subsequent screens) of underlying incidence, and in the second year to 52% (55%). Generally, interval cancers had a more favourable tumour size distribution than breast cancer in not (yet) screened women. The Dutch programme detected relatively less (favourable) invasive cancers in initial screens than the UK programme, whereas the number of interval cancers confirms UK findings. Measures should be considered to improve the detection of small invasive cancers and to reduce false-negative rates, even if this will lead to increasing referral rates. © 1999 Cancer Research Campaign

Keywords: breast cancer, interval cancer, proportionate incidence, population-based screening, evaluation

Full Text

The Full Text of this article is available as a PDF (100.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Boer R., de Koning H., Threlfall A., Warmerdam P., Street A., Friedman E., Woodman C. Cost effectiveness of shortening screening interval or extending age range of NHS breast screening programme: computer simulation study. BMJ. 1998 Aug 8;317(7155):376–379. doi: 10.1136/bmj.317.7155.376. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brekelmans C. T., Collette H. J., Collette C., Fracheboud J., de Waard F. Breast cancer after a negative screen: follow-up of women participating in the DOM Screening Programme. Eur J Cancer. 1992;28A(4-5):893–895. doi: 10.1016/0959-8049(92)90144-q. [DOI] [PubMed] [Google Scholar]
  3. Day N., McCann J., Camilleri-Ferrante C., Britton P., Hurst G., Cush S., Duffy S. Monitoring interval cancers in breast screening programmes: the east Anglian experience. Quality Assurance Management Group of the East Anglian Breast Screening Programme. J Med Screen. 1995;2(4):180–185. doi: 10.1177/096914139500200402. [DOI] [PubMed] [Google Scholar]
  4. Faux A. M., Richardson D. C., Lawrence G. M., Wheaton M. E., Wallis M. G. Interval breast cancers in the NHS Breast Screening Programme: does the current definition exclude too many? J Med Screen. 1997;4(3):169–173. doi: 10.1177/096914139700400310. [DOI] [PubMed] [Google Scholar]
  5. Fracheboud J., de Koning H. J., Beemsterboer P. M., Boer R., Hendriks J. H., Verbeek A. L., van Ineveld B. M., de Bruyn A. E., van der Maas P. J. Nation-wide breast cancer screening in The Netherlands: results of initial and subsequent screening 1990-1995. National Evaluation Team for Breast Cancer Screening. Int J Cancer. 1998 Mar 2;75(5):694–698. doi: 10.1002/(sici)1097-0215(19980302)75:5<694::aid-ijc6>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  6. Garvican L., Littlejohns P. An evaluation of the prevalent round of the breast screening programme in south east Thames, 1988-1993: achievement of quality standards and population impact. J Med Screen. 1996;3(3):123–128. doi: 10.1177/096914139600300304. [DOI] [PubMed] [Google Scholar]
  7. Klemi P. J., Toikkanen S., Räsänen O., Parvinen I., Joensuu H. Mammography screening interval and the frequency of interval cancers in a population-based screening. Br J Cancer. 1997;75(5):762–766. doi: 10.1038/bjc.1997.135. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Moss S. M., Coleman D. A., Ellman R., Chamberlain J., Forrest A. P., Kirkpatrick A. E., Thomas B. A., Price J. L. Interval cancers and sensitivity in the screening centres of the UK trial of early detection of breast cancer. Eur J Cancer. 1993;29A(2):255–258. doi: 10.1016/0959-8049(93)90187-k. [DOI] [PubMed] [Google Scholar]
  9. Moss S. M., Michel M., Patnick J., Johns L., Blanks R., Chamberlain J. Results from the NHS breast screening programme 1990-1993. J Med Screen. 1995;2(4):186–190. doi: 10.1177/096914139500200403. [DOI] [PubMed] [Google Scholar]
  10. Nab H. W., Voogd A. C., Crommelin M. A., Kluck H. M., vd Heijden L. H., Coebergh J. W. Breast cancer in the southeastern Netherlands, 1960-1989: trends in incidence and mortality. Eur J Cancer. 1993;29A(11):1557–1559. doi: 10.1016/0959-8049(93)90294-p. [DOI] [PubMed] [Google Scholar]
  11. Peeters P. H., Verbeek A. L., Hendriks J. H., Holland R., Mravunac M., Vooijs G. P. The occurrence of interval cancers in the Nijmegen screening programme. Br J Cancer. 1989 Jun;59(6):929–932. doi: 10.1038/bjc.1989.196. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Prior P., Woodman C. B., Wilson S., Threlfall A. G. Reliability of underlying incidence rates for estimating the effect and efficiency of screening for breast cancer. J Med Screen. 1996;3(3):119–122. doi: 10.1177/096914139600300303. [DOI] [PubMed] [Google Scholar]
  13. Schouten L. J., de Rijke J. M., Schlangen J. T., Verbeek A. L. Evaluation of the effect of breast cancer screening by record linkage with the cancer registry, The Netherlands. J Med Screen. 1998;5(1):37–41. doi: 10.1136/jms.5.1.37. [DOI] [PubMed] [Google Scholar]
  14. Sylvester P. A., Vipond M. N., Kutt E., Davies J. D., Webb A. J., Farndon J. R. A comparative audit of prevalent, incident and interval cancers in the Avon breast screening programme. Ann R Coll Surg Engl. 1997 Jul;79(4):272–275. [PMC free article] [PubMed] [Google Scholar]
  15. Tabár L., Faberberg G., Day N. E., Holmberg L. What is the optimum interval between mammographic screening examinations? An analysis based on the latest results of the Swedish two-county breast cancer screening trial. Br J Cancer. 1987 May;55(5):547–551. doi: 10.1038/bjc.1987.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Vitak B., Stål O., Månson J. C., Thomas B. A., Arnesson L. G., Ekelund L., Måre K., Nordenskjöld B., Källström A. C., Bång H. Interval cancers and cancers in non-attenders in the Ostergötland Mammographic Screening Programme. Duration between screening and diagnosis, S-phase fraction and distant recurrence. Eur J Cancer. 1997 Aug;33(9):1453–1460. doi: 10.1016/s0959-8049(97)00185-8. [DOI] [PubMed] [Google Scholar]
  17. Woodman C. B., Threlfall A. G., Boggis C. R., Prior P. Is the three year breast screening interval too long? Occurrence of interval cancers in NHS breast screening programme's north western region. BMJ. 1995 Jan 28;310(6974):224–226. doi: 10.1136/bmj.310.6974.224. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. de Koning H. J., Boer R., Warmerdam P. G., Beemsterboer P. M., van der Maas P. J. Quantitative interpretation of age-specific mortality reductions from the Swedish breast cancer-screening trials. J Natl Cancer Inst. 1995 Aug 16;87(16):1217–1223. doi: 10.1093/jnci/87.16.1217. [DOI] [PubMed] [Google Scholar]
  19. de Koning H. J., van Ineveld B. M., van Oortmarssen G. J., de Haes J. C., Collette H. J., Hendriks J. H., van der Maas P. J. Breast cancer screening and cost-effectiveness; policy alternatives, quality of life considerations and the possible impact of uncertain factors. Int J Cancer. 1991 Oct 21;49(4):531–537. doi: 10.1002/ijc.2910490410. [DOI] [PubMed] [Google Scholar]
  20. van Oortmarssen G. J., Habbema J. D., van der Maas P. J., de Koning H. J., Collette H. J., Verbeek A. L., Geerts A. T., Lubbe K. T. A model for breast cancer screening. Cancer. 1990 Oct 1;66(7):1601–1612. doi: 10.1002/1097-0142(19901001)66:7<1601::aid-cncr2820660727>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  21. van den Akker-van Marle E., de Koning H., Boer R., van der Maas P. Reduction in breast cancer mortality due to the introduction of mass screening in The Netherlands: comparison with the United Kingdom. J Med Screen. 1999;6(1):30–34. doi: 10.1136/jms.6.1.30. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES