S. Borgquist (Aarhus, Denmark)
Aarhus University HospitalAuthor Of 2 Presentations
54P - Overweight and prognosis in triple-negative breast cancer patients: a systematic review and meta-analysis
Abstract
Background
The purpose is to conduct a systematic review and meta-analysis evaluating the impact of overweight on prognosis in triple-negative breast cancer (TNBC) patients.
Methods
Systematic searches were conducted in PubMed and Embase using variations of the search terms triple-negative breast neoplasms (population), overweight and/or obesity (exposure), and prognosis (outcome). Data were extracted from longitudinal observational studies, which used survival statistics with hazard ratios (HRs) to examine disease-free survival and/or overall survival according to body mass index measured at the time of diagnosis of TNBC. Overweight was defined using the World Health Organization guidelines. Guided by the Meta-analysis of Observational Studies in Epidemiology (MOOSE) checklist, study data were extracted and study quality assessed with the Newcastle-Ottawa Scale independently by two authors. The effect sizes (HRs) were combined with random-effects models, and the results were evaluated and adjusted for possible publication bias.
Results
The study selection process identified 11 eligible studies of 5,556 TNBC patients. The pooled estimates indicated that, relative to non-overweight, overweight was associated with both shorter disease-free survival (HR=1.33; 95%CI: 1.13–1.58) and shorter overall survival (HR=1.39; 95%CI: 1.15-1.69). Supplementary Bayesian meta-analyses showed strong evidence for non-zero effects, with the alternative hypothesis being 12.7 and 13.5 times more likely than the null-hypothesis for disease-free survival and overall survival, respectively.
Conclusions
Relative to non-overweight, overweight was associated with a shorter disease-free and overall survival among TNBC patients.
Legal entity responsible for the study
Aarhus University.
Funding
Slagtermester Max Wørzner og Hustru Wørzners Memorial Foundation, Health Research Foundation of Central Denmark Region, Aarhus University.
Disclosure
R. Zachariae: Honoraria (self), Shareholder/Stockholder/Stock options, None of this had any role in the design, data collection, analysis, or preparation of the manuscript: Novo Nordisk. S. Borgquist: Honoraria (self), Travel/Accommodation/Expenses, None of this had any role in the design, data collection, analysis, or preparation of the manuscript: Pfizer; Honoraria (self), Travel/Accommodation/Expenses, None of this had any role in the design, data collection, analysis, or preparation of the manuscript: Roche. All other authors have declared no conflicts of interest.
168P - Danish women favour hypothetical breast cancer screening with harms, but no benefits
Abstract
Background
Aimed at reducing breast cancer mortality, mammography screening programs have been implemented in many countries. However, the extent and balance between benefits and harms of such screening programs remain contested. Therefore, transparent and balanced information on benefits and harms is recommended as basis for informed decision-making. Previous studies found that informed decision-making was challenged by overly positive attitudes towards cancer screening. In particular, that an objective decision might be challenged by strong emotions, and worry, fear and anxiety of having breast cancer. Thus, we hypothesized that a large proportion of women would be willing to participate in screening regardless of the presented information. We aimed to estimate the prevalence of Danish women’s willingness to participate in a hypothetical mammography screening with no health benefits, only harms.
Methods
We invited a random sample of 768 healthy women in the non-screening population aged 44-49 in the Central Denmark Region to an online survey. After presentation of a hypothetical screening, the survey captured screening attitudes, breast cancer worry, perceived likelihood of breast cancer, assessment of the hypothetical screening test and information on breast cancer history and health literacy. Data were subsequently linked to register data on sociodemographic factors.
Results
A total of 323 (42.1%, 95% CI: 38.5-45.6) women filled in the questionnaire. Hereof, 247/300 (82.3%, 77.5-86.5) were willing to participate in the hypothetical mammography screening with no benefits, only harms. Women were generally very certain about their decision to participate, 63.2% (56.8-69.2) and 52.8% (38.6-66.7) in the participation and non-participation group, respectively. Yet, more than two-thirds in both groups seemed to understand the presented information and responded that the screening did not reduce breast cancer mortality.
Conclusions
A high percentage of women in this study were willing to participate in the hypothetical screening with harms, but no health benefits. Surprisingly, most women understood that the screening did not reduce breast cancer mortality. This indicates that Danish women are unduly positive about mammography screening.
Clinical trial identification
NCT04509063 Registered at Aarhus University: 2016-051-000001, 1835 The project was approved by the Institutional Review Board at Aarhus University, 2020-0094925, 2020-34.
Legal entity responsible for the study
Henrik Støvring and Eeva-Liisa Røssell Johansen.
Funding
Department of Public Health, Aarhus University, Denmark.
Disclosure
All authors have declared no conflicts of interest.