Evidence map›Paper›PMID 41707694›Full record

ArticleJournal of the National Cancer Institute2026

Improved stage-specific survival in screen-detected breast cancer in Denmark: a cohort study.

Amy Tickle, Judith Offman, Bernard North, Susanne Fogh Jørgensen, Sisse Njor, Peter Sasieni

Abstract read
In one paragraph

Article in Journal of the National Cancer Institute, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Amy TickleComprehensive Cancer Centre, King's College London, Guy's Campus, London, United Kingdom.ORCID 0009-0000-8246-0702
Judith OffmanWolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.ORCID 0000-0001-5604-1635
Bernard NorthWolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.ORCID 0000-0001-9504-2294
Susanne Fogh JørgensenDepartment of Regional Health Research, University of Southern Denmark, Odense, Denmark.ORCID 0000-0003-4534-0351
Sisse NjorDepartment of Regional Health Research, University of Southern Denmark, Odense, Denmark.ORCID 0000-0003-0429-4176
Peter SasieniWolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom.ORCID 0000-0003-1509-8744

Funding

Barts Charity G-001522Barts Charity G-001522, MGU0461Barts Charity MGU0461NNF22OC0076184Novo Nordisk FoundationNovo Nordisk Foundation NNF22OC0076184The Cancer Research UK Programme C8162/A29083The Cancer Research UK Programme grant C8162/A29083
6 · The paper itself

Abstract

backgroundThis study examined whether breast cancer survival improvements with screening are explained solely by detection at early stages and whether mortality can be predicted using stage and diagnosis date alone.

methodsWe compared stage-specific net survival between never-screened, symptomatic ever-screened (past attenders and interval cancers), and screen-detected breast cancer cases in Denmark using individual-level electronic health records from January 1, 2010 to December 31, 2022. Lifetables were generated from women without breast cancer, separately for never-screened and ever-screened women. Age-specific all-cause mortality rates were used to calculate excess mortality in women with breast cancer, which was then transformed into net survival.

resultsOf 817 128 women, 32 827 had breast cancer, with 8% presenting as stage III or IV. Survival differences between symptomatic and screen-detected cases were minimal for stages I-III but reached 40% at stage IV, with 5-year net survival for stage IV screen-detected women (74.7%) resembling stage IIIc symptomatic survival in never-screened women (72.6%). Survival from stage IV breast cancer was strongly associated with treatment, with median survival (years) of 4.4-6.0 with surgery, 1.6-2.2 with nonsurgical treatment, and 0.03-0.13 with no treatment; 67% of screen-detected patients received surgery (compared with 23% of never-screened and 27% of symptomatic ever-screened).

conclusionsGreater survival in screen-detected stage IV cases suggests that breast cancer screening may not have come too late and deserves to be investigated further. Predicting breast cancer mortality using stage at diagnosis and stage-specific survival (without differentiating by route to diagnosis) will underestimate the impact of breast screening on mortality.

Indexed as

Breast NeoplasmsEarly Detection of CancerAdultAgedCohort StudiesDenmarkFemaleHumansMammographyMass ScreeningMiddle AgedNeoplasm StagingSurvival Ratebreast cancerbreast screeningexcess mortalitylate-stagemammographymetastaticmetastatisisnet survivaloligometastaticorganised breast screening programsroute to diagnosisscreen-detectedstage 4stage at diagnosisstage-specific survival

Identifiers

PMID41707694
PMCPMC13247330

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.