Use the graph below to identify which of the statements below are correct.(Note that the UK breast cancer screening programme began in 1988.) (Select all that apply) Age‐standardised breast cancer mortality rates in the UK, 1971‐2012 (From Cancer
Research UK - Breast cancer mortality statistics;
Http://www.cancerresearchuk.org/health‐professional/cancer‐statistics/statistics‐
By‐cancer‐type/breast‐cancer/mortality#heading‐Two accessed October 8, 2015.
A)It is clear from this graph that the introduction of breast cancer screening into the UK has led to a consequent decline in deaths from breast cancer
B)Using simple descriptive data like those in this figure is too crude to be a useful way to assess whether the screening programme is working
C)The graph can be described as follows: "This figure shows the trends in the annual age‐standardised mortality rate for breast cancer in the UK between 1971 and 2012. From a level of ~37 deaths per 100,000 women in 1971 the rate rose steadily to About 1984 where it peaked at around 42, remaining fairly stable for 5 years before Starting a steady decline; this slowed slightly after about a decade, to reach a rate of ~24÷100,000 in 2012"
D)Without seeing overall mortality trends the graph cannot be interpreted correctly
E)If we knew the incidence rates of breast cancer over the same period we could fully interpret the mortality data to decide if the screening programme was responsible For the improvements over the past 2 decades

Question

Use the graph below to identify which of the statements below are correct.(Note that the UK breast cancer screening programme began in 1988.) (Select all that apply)  Age‐standardised breast cancer mortality rates in the UK, 1971‐2012 (From Cancer
Research UK - Breast cancer mortality statistics;
Http://www.cancerresearchuk.org/health‐professional/cancer‐statistics/statistics‐
By‐cancer‐type/breast‐cancer/mortality#heading‐Two accessed October 8, 2015.
A)It is clear from this graph that the introduction of breast cancer screening into the UK has led to a consequent decline in deaths from breast cancer 
B)Using simple descriptive data like those in this figure is too crude to be a useful way to assess whether the screening programme is working 
C)The graph can be described as follows: "This figure shows the trends in the annual age‐standardised mortality rate for breast cancer in the UK between 1971 and 2012. From a level of ~37 deaths per 100,000 women in 1971 the rate rose steadily to About 1984 where it peaked at around 42, remaining fairly stable for 5 years before Starting a steady decline; this slowed slightly after about a decade, to reach a rate of ~24÷100,000 in 2012" 
D)Without seeing overall mortality trends the graph cannot be interpreted correctly 
E)If we knew the incidence rates of breast cancer over the same period we could fully interpret the mortality data to decide if the screening programme was responsible For the improvements over the past 2 decades

Quizplus · Accepted Answer

Only C is completely correct.The description of the graph given in (C) is
quite accurate.We might also have gone beyond a simple description of the mortality
pattern to note that the decline started a few years after the introduction of the
screening programme, which would fit with a causal influence of the programme.Had
there been little change in breast cancer mortality the screening effort would probably
have been in vain so such data are in fact critical in assessing programme effectiveness
(B).However proper interpretation requires considering other factors which might
lower mortality (which (A) does not do).If incidence rates were falling (E), then
mortality would follow (all else being equal), but there is also another important factor
in disease control which is whether and when new treatments for breast cancer were
introduced.As it happened there were such treatment improvements at about the
same time as screening commenced, and both have contributed to the fall, perhaps
about equally.And while effective screening programmes will lower rates of the specific
disease they target, the change in total mortality is trivial, so overall mortality rates
cannot assist interpretation of such a trend (D).

Use the Graph Below to Identify Which of the Statements