Journal of the National Cancer Institute
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Swedish women aged 40-69 years were gradually offered regular mammography screening since 1974, and nationwide coverage was achieved in 1997. We hypothesized that this gradual implementation of breast cancer screening would be reflected in county-specific mortality patterns during the last 20 years. ⋯ From 1972 to 2009, breast cancer mortality rates in Swedish women aged 40 years and older declined by 0.98% annually, from 68.4 to 42.8 per 100,000, and it continuously declined in 14 of the 21 Swedish counties. In three counties, breast cancer mortality declined sharply during or soon after the implementation of screening; in two counties, a steep decline started at least 5 years after screening was introduced; and in two counties, breast cancer mortality increased after screening started. In counties in which screening started in 1974-1978, mortality trends during the next 18 years were similar to those before screening started, and in counties in which screening started in 1986-1987, mortality increased by approximately 12% (P = .007) after the introduction of screening compared with previous trends. In counties in which screening started in 1987-1988 and in 1989-1990, mortality declined by approximately 5% (P = .001) and 8% (P < .001), respectively, after the introduction of screening. Conclusion County-specific mortality statistics in Sweden are consistent with studies that have reported limited or no impact of screening on mortality from breast cancer.
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Noncommunicable diseases were estimated to claim more than 36 million lives worldwide in 2008. Major contributors to this burden were cardiovascular disease, cancer, chronic respiratory diseases, and diabetes. The United Nations General Assembly held a high-level meeting on noncommunicable diseases in September 2011 for heads of states and governments, conscious of the projected increases in disease incidence, particularly in low- and middle-income countries. ⋯ Preparations for the meeting elicited enormous attention from governments and nongovernmental organizations, but the engagement of the research community was less evident. This commentary calls for the involvement of the cancer research community in response to the further action detailed in the United Nations Political Declaration emanating from the meeting, identifies a number of cancer-specific priorities, including vaccination against hepatitis B virus and human papillomavirus, cervical cancer screening, and early detection of breast cancer, and suggests areas where cancer research can provide the evidence base for cancer control, notably in improving the quality and coverage of cancer registration, elucidating cancer etiology, and evaluating interventions, including their implementation in low-resource health-care settings. Finally, the need for global cooperation in developing a research agenda for low- and middle-income countries is highlighted.
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J. Natl. Cancer Inst. · Jul 2012
ReviewQuality of reporting of modern randomized controlled trials in medical oncology: a systematic review.
The Consolidated Standards of Reporting Trials (CONSORT) guidelines were developed in the mid-1990s for the explicit purpose of improving clinical trial reporting. However, there is little information regarding the adherence to CONSORT guidelines of recent publications of randomized controlled trials (RCTs) in oncology. ⋯ The results show that numerous items remained unreported for many trials. Thus, given the potential impact of poorly reported trials, oncology journals should require even stricter adherence to the CONSORT guidelines.