Doctoral defence: Aleksei Baburin "Breast cancer incidence, mortality and survival in Estonia in the context of health care system changes and screening"

On November 22th 2024 Aleksei Baburin will defend his thesis "Breast cancer incidence, mortality and survival in Estonia in the context of health care system changes and screening".

Supervisors:
Research professor Kaire Innos, Tervise Arengu Instituut
Associate professor Katrin Lang, University of Tartu

Opponent: 
Janne Pitkäniemi, Director of Statistics at Finnish Cancer Registry, Finland 

Summary:
Breast cancer is the most common cancer in women in Estonia. Mammography screening aimed at detecting cancer early and thereby reducing breast cancer mortality was implemented in 2004. However, the targeted age range has not been as wide as recommended and participation has remained low.

The aim of the thesis was to evaluate long-term trends in breast cancer incidence, mortality and survival in Estonia in the context of changes in society and health care system and the introduction of mammography screening program.

The study used data from Estonian cancer registry and causes of death registry and a variety of analytic techniques. Breast cancer incidence in Estonia is slowly increasing, mainly on the account of early stages. In parallel, there has been a decline in the incidence of late stages. Breast cancer mortality has been decreasing since late 1990s, most rapidly in women aged 40–79 years. In older birth cohorts, mortality increased with increasing age, but in cohorts invited to screening, mortality stabilized or started to decline after entering screening age. When comparing mortality during equal-length periods before and after the introduction of screening, a significant mortality drop was seen in young women as well as those invited to screening, while there was no drop in older women. Breast cancer survival has increased considerably over the past 30 years in all age groups. By stage, survival has increased the most for stages III and IV.  

The results suggest that despite low participation, mammography screening in combination with increased awareness and more effective diagnostic and treatment practices has had a significant mortality benefit in Estonia. To further reduce breast cancer mortality, efforts are needed to tackle risk factors, ensure the implementation of high-quality screening program, reduce delays in women who have developed symptoms, and provide up-to-date treatment as well as psychosocial support for all cancer patients.

You can watch defense via Teams.