Breast Cancer Screening by Physical Examination: Randomized Trial in the Phillipines
INTERNATIONAL AGENCY FOR RESEARCH ON CANCER LYONS (FRANCE)
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In 1990 breast cancer accounted for 795,000 new cases per year Ferlay et a., 1998, and it was the most frequent cancer in women. Incidence rates are still rising in many countries, particularly in the developing world Coleman and Esteve, 1993. It seems that these trends are likely to continue, since the current pattern of later childbearing, decreasing fertility, and westernization of diets will all be associated with increased risk. At present, our knowledge of environmental risk factors does not permit formulation of any practical primary prevention programs. The introduction of adjuvant therapy with Tamoxifen has improved survival of older cases and a decline of mortality from breast cancer below age 50, observed in some highrisk countries, has also been attributed to adjuvant therapy Nab et a., 1994, Olivotto et a., 1994. However, further improvements in surgical techniques, or in radiotherapy, are very unlikely to provide more than marginal changes in mortality rates.
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