Primary fields of research:
1. What factors determine who benefits most from breast cancer screening?
- Breast tissue density at the first screening. The incidence of breast cancer is higher in women with dense breast tissue, and changes in the breast are less visible in mammograms of women with dense breast tissue.
- Benign changes in the breast before screening. The incidence of breast cancer is higher in women with a history of benign breast changes. The sensitivity and specificity of the screening is also lower in these women.
- General health condition before the screening.
- Hormone treatment during menopause.
- Calculation of cumulative breast cancer incidence in screened and unscreened women, at risk intervals determined by the status of women in the screening programme.
- The significance of better staging and diagnosis of ductal carcinoma in situ (DCIS) in order to reduce breast cancer mortality.
3. Risk factors in various screening results.
4. Breast cancer incidence in women who undergo genetic counselling and testing.
The Centre has also entered into a contract with the Capital Region to help monitor mammography screening in the region. We are compiling indicators, etc. for national monitoring. We also contribute to the European guidelines for mammography screening.
In 2003, there were 408 Danish women diagnosed with cervical cancer, and 148 women died of the disease in 2001. These relatively small numbers reflect a considerable effort to identify the precursors of cervical cancer. Annually, the country treats around 5,000 women for precursors detected by screening. Organised screening has helped reduce the incidence of invasive cervical cancer, while a 10-year break in organised screening programme led to an increase in the incidence rate. About 70% of the cases of cervical cancer are caused by continuous infection with one of two types of human papillomavirus. In future, these infections will be vaccinated against. However, since vaccination does not protect a women from the disease 100%, a combination of vaccination and screening will be necessary. Our cervical cancer research falls in three topic areas:
1. Natural history of cervical cancer
- Changes in the detection rate of precursors
2. Optimisation of screening and treatment
- Are patients with cervical cancer unscreened, or are their results misinterpreted?
- Should women above 60 years be invited for screening?
- Is there any advantages to refusing smear samples that lack endocervical cells?
- Treatment and outcome indicators
3. Combining of vaccination and screening
- In the future, who should be screened, how and how often?
- Basis for future European guidelines
The Centre also helps compile indicators for national monitoring. It also contributes to the development of European guidelines for future screening policies.
Finally, the Centre is part of:
- The European Cancer Network
- The European Network for Information on Cancer
- The International Cancer Screening Network, chaired by the United States National Cancer Institute.
- The European Cancer Health Indicator Project.