Attempts to evaluate a non-randomized breast cancer screening programme (the 'DOM-project')

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• A non-randomized breast cancer screening program was established in Utrecht, The Netherlands, in December 1974.
• The program targeted women born between 1911 and 1925.
• Initial organization, response rates, and early outcomes were positive.

Purpose of the Study:

• To analyze the long-term benefits of the Utrecht breast cancer screening program.
• To compare long-term outcomes with mortality data from Dutch cities without screening programs.

Main Methods:

• Comparative analysis of mortality data between Utrecht and other large Dutch cities.
• A case-control study was conducted to assess the odds ratio of breast cancer mortality.

Main Results:

• No significant differences in long-term outcomes were observed when comparing Utrecht with other cities.
• The case-control study indicated a potential long-term benefit: an odds ratio of 0.29 (95% CI: 0.14-0.62) for dying from breast cancer among ever-screened women compared to never-screened women.

Conclusions:

• While direct comparison of city mortality data showed no major differences, a case-control study suggests a long-term reduction in breast cancer mortality for screened women.
• Further investigation into the long-term impact of organized screening programs is warranted.