BREAST CANCER IN SLOVENIA: EPIDEMIOLOGY AND SCREENING
Abstract
Background. Breast is the most frequent cancer site in Slovenian female population. In the year 2000 there were 932 new breast cancer cases registered (91.2/100,000), the incidence is expected to increase in the next ten years. Primary prevention includes general recommendations for healthy life style, e.g. avoidance of obesity, diet, physical activity and moderate alcohol consumption. Randomised controlled trials conducted in the USA, Canada, Scotland and Sweden have shown that regular mammography, alone or in combination with clinical examination, is effective in reducing mortality for about 25% in women over the age of 50, and much less in younger population. However, mammography screening has several drawbacks, the major being its tendency towards false positive and false negative results with all their potential psychosocial consequences. High quality assurance and control, as well as effective and readily available diagnostics and treatment, all of which demand high investments, are indispensable for good results.
Conclusions. In Slovenia there are standards for breast cancer screening units, but their implementation in every day’s work is still a problem. In any case, breast cancer control could be achieved only by combined efforts directed into primary prevention and early detection, as well as by improving availability of effective treatment.
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References
Incidenca raka v Sloveniji 2000. Ljubljana: Onkološki inštitut – Register raka za Slovenijo, 2003.
Pompe-Kirn V, Zakotnik B, Zadnik V. Preživetje bolnikov z rakom v Sloveniji. Ljubljana: Onkološki inštitut, 2003 v tisku.
Key TJ, Verkasalo PK, Banks E. Epidemiology of breast cancer. Lancet Oncol 2001; 2: 133–40.
Cuzick J. A brief review of the current breast prevention trials and proposals for futuretrials. Eur J Cancer 2000; 36: 1298–302.
Smith RA. Screening fundamentals. J Natl Cancer Inst Monogr 1997; 22: 15–9.
Breast cancer screening. IARC handbooks on cancer prevention 2002; 7: 179–81.
Kerlikowske K, Grady D, Rubin SM et al. Efficacy of screening mammography. A meta-analysis. JAMA 1995; 273: 149–54.
Gotzche PC, Olsen O. Is screening for breast cancer justifiable? Lancet 2000; 355: 129–34.
Olsen O, Gotzche PC. Cochrane review on screening for breast cancer with mammography. Lancet 2001; 358: 1340–2.
Advisory Committee on Cancer Prevention. Recommendations on cancer screening in the European Union. Eur J Cancer 2000; 36: 1473–8.
Kerlikowske K. Efficacy of screening mammography among women aged 40–49 years and 50–69 years. Comparison of relative and absolute benefit. J Natl Cancer Inst Monogr 1997; 22: 79–86.
Fletcher SW, Elmore JG. Mammographic screening for breast cancer. N Engl J Med 2003; 348: 1672–80.
Feig SA, Hendrick E. Radiation risk from screening mammography of women aged 40–49 years. J Natl Cancer Inst Monogr 1997; 22: 119–24.
Elmore JG, Barton MB, Moceri VM et al. Ten-year risk of false positive screening mammograms and clinical breast examinations. New Engl J Med 1998; 338: 1089–96.
National Institutes of Health Consensus Development Panel. National Institutes of Health consensus Development conference statement: breast cancer screening for women ages 40–49, January 21–23, 1997. J Natl Cancer Inst 1997; 89: 1015–26.
Zoetelief J, Fitzgerald M, Leitz W, Sabel M. European protocol on dosimetry in mammography. Luxembourg: Office for the Official Publications of the European Communities, 1996.
Perry N, Broeders M, deWolf, Tornberg S eds. European guidelines for quality assurance in mammography screening. Luxemburg: Office for Official Publications of the European Communities, 2001.
Eusoma. The requirements of a specialist breast unit. Eur J Cancer 2000; 36: 2288–93.
Navodilo o spremembah in dopolnitvah navodila za izvajanje preventivnega zdravstvenega varstva na primarni ravni. Ljubljana 2002. Uradni list RS, 2002; 9: 1–11.
Jančar B, Primic Žakelj M, Novak Ž, Zdešar U, Pirc S. Strokovne smernice za preventivne preglede dojk v Sloveniji. (Dopolnjeno s pripombami Razširjenega strokovnega kolegija za onkologijo v juniju 2001). Ljubljana 2001; 1–21.
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