Self-reported symptoms among participants in a population-based screening program

Area of Science:

• Oncology
• Radiology
• Public Health

Background:

• Limited research exists on the link between self-reported symptoms and breast cancer risk in population-based screening.
• Understanding this association is crucial for optimizing screening program efficacy.

Purpose of the Study:

• To investigate the association between self-reported breast symptoms and the risk of screen-detected and interval breast cancers.
• To analyze the characteristics of tumors in relation to reported symptoms.

Main Methods:

• Descriptive statistics and logistic regression analyses were performed on data from 785,642 women aged 50-69 attending BreastScreen Norway (1996-2016).
• Women were categorized by reported symptoms: asymptomatic, lump, or skin/nipple changes.
• Associations between symptom groups and cancer detection (screen-detected or interval) were analyzed, with results presented as odds ratios (OR) and 95% confidence intervals (CI).

Main Results:

• 6.2% of screening examinations involved women reporting a lump or skin/nipple changes.
• The rate of screen-detected cancer was substantially higher for women with a reported lump (45.2/1000 examinations) compared to asymptomatic women (5.1/1000).
• Women with a reported lump had significantly higher adjusted ORs for screen-detected cancer (10.1) and interval cancer (2.0) compared to asymptomatic women. Tumors in symptomatic women also showed less favorable histopathological characteristics.

Conclusions:

• A notable proportion of women attending breast cancer screening report symptoms, despite the program's focus on asymptomatic individuals.
• Self-reported symptoms, particularly a lump, are strongly associated with an increased risk of both screen-detected and interval breast cancers.
• Implementing standardized follow-up guidelines for women reporting symptoms during screening may enhance early detection and patient outcomes.