MedicalResearch.com Interview with:
Stephen W. Duffy
Professor of Cancer Screening
Wolfson Institute of Preventive Medicine,
Barts and The London School of Medicine and Dentistry
Queen Mary University of London
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The phenomenon of length bias, whereby screening has more chance of detecting slow growing tumours, has been known about for some years. This has led some colleagues to speculate that breast cancer screening only benefits those with slow-growing, less aggressive cancers, and does not reduce deaths from more aggressive, rapidly progressing cancers.
In this study, we addressed this question directly using data from a randomised trial of mammographic screening. We calculated the reduction in mortality from grade 1 (less aggressive), grade 2 (intermediate) and grade 3 (most aggressive) cancers, as a result of screening. We found that the greatest reduction in breast cancer mortality was from the aggressive, fast-growing grade 3 cancers, contrary to what had been suspected.
MedicalResearch.com: What should readers take away from your report?
Response: First, only a minority of women actually develop breast cancer, and only a minority of them have the aggressive grade 3 type. However, if you are unlucky enough to develop such a cancer, catching it early as a result of screening makes it much more likely to be treated successfully and not to prove fatal.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: It would be interesting to see if similar results are observed with respect to more recent measures of biological aggressiveness of cancers, such as those based on gene expression.
Disclosures: I have in the past received research grant funding from Philips to investigate imaging possibilities to distinguish fluid from solid lesions in the breast.
Laszlo Tabar, Tony Hsiu-Hsi Chen, Amy Ming-Fang Yen, Sam Li-Sheng Chen, Jean Ching-Yuan Fann, Sherry Yueh-Hsia Chiu, May M.S. Ku, Wendy Yi-Ying Wu, Chen-Yang Hsu, Yu-Ying Chen, Kerri Beckmann, Robert A. Smith and Stephen W. Duffy
Cancer Epidemiology, Biomarkers & Prevention
DOI: 10.1158/1055-9965.EPI-17-0487 Published February 2018
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