Detection of ductal carcinoma in situ and subsequent interval cancers

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i551 (Published 01 February 2016) Cite this as: BMJ 2016;352:i551
  1. Yiwey Shieh, fellow1,
  2. Martin Eklund, associate professor2,
  3. Laura Esserman, professor3
  1. 1Division of General Internal Medicine University of California, San Francisco, CA, USA
  2. 2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  3. 3Departments of Surgery and Radiology, University of California, San Francisco, 1600 Divisadero Street, Box 1710, San Francisco, CA 94115, USA
  1. Correspondence to: L Esserman laura.esserman{at}ucsfmedctr.org

Recent paper provides lessons for smarter screening

The recent report by Stephen Duffy and colleagues sheds light on the relation between the detection of ductal carcinoma in situ (DCIS) and subsequent interval cancer rates.1 Using data from the UK National Health Service Breast Screening Programme (NHSBSP), the authors report on detection rates of DCIS in women aged 50-69 across four years (2003-07). They also report on interval cancer detection rates in the 36 months after the index screen and examine the effect of detecting DCIS on subsequent interval cancer rates. They estimate that, for DCIS detection rates up to 1.5 per 1000 women screened, there is one fewer invasive interval cancer over the subsequent three years for every three cases of DCIS.

The findings support the benefit of detecting DCIS in the context of the UK screening programme, the practices of which are particularly informative but different from those in the United States. Screening in the UK occurs triennially, compared with biennially in most …

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