Stage-specific incidence of XXXX before the beginning of organized screening programs in Italy.

@entity5 @entity1 @entity1442 @entity0
OBJECTIVE: To measure stage-specific geographic and time variability of @entity0 in seven Italian areas before the onset of organized screening programs. METHODS: All invasive @entity5 (8689 cases) arising in @entity1 aged 40-79 years during the pre-screening period 1985-1997, were considered. Multiple Poisson regression analysis was performed. RESULTS: About 39% of the cases were classified as "early," 52% as "advanced," and 9% as "unspecified" stage. Age-adjusted incidence rates showed a significant geographic variation for early but not for advanced @entity5 (range: 58-103 cases/100,000 and 104-125 cases/100,000, respectively). The result was confirmed in the multiple regression analysis after adjustment for year of diagnosis and age. Early @entity0 risk adjusted for age and registry showed a significant increase over time (+3.9% per year for all ages, and +6.2% per year for age category 50-79). In contrast, a decreasing time trend was observed for advanced @entity5 of 3 cm or over in @entity1 aged less than 60. CONCLUSIONS: In our study, early @entity0 incidence varied both by geographic area and time before the commencement of screening. The differences in early-stage incidence may well be related to differences in availability of "spontaneous" mammography. Late-stage incidence decreased over time in younger @entity1 and for very advanced cases, but not in the older ones, nor for @entity5 less than 3 cm. Early detection outside organized screening was only partially efficient in reducing advanced @entity0 incidence. The trend of incidence of @entity1442 , as previously proposed, is confirmed to be a valid early indicator of effectiveness of screening.
