Contribution and Performance of Mobile Units in an Organized Mammography Screening Program

Abstract

Breast cancer screening enables early detection of breast cancer which leads to a reduction in mortality.1,2 The Quebec breast cancer screening program began in 1998 and offers women aged 50-69 a biennial screening mammography. 3 Since 2002, three mammography mobile units were progressively added to the program. The program relies on two motorized units and a portable unit transported by plane or boat that extends screening services to regions not accessible by land. In the present study, we use the term "mobile units" to refer to both (motorized and portable) types of mammography units. The purpose of these units is to provide services to regions not covered by fixed centres. In addition, they can provide temporary relief to fixed centres that have insufficient resources to ensure timely breast screening.Mobile units have been added to screening programs in various countries to increase geographical accessibility to breast cancer screening. 4 Studies have shown that mobile units are effective at improving the participation rate, 5-7 that mobile units can decrease barriers to screening for hard-to-reach populations 8 and that educational interventions associated with mobile unit visits can increase adherence.9 However, mobile units have different operating practices when compared to stationary (fixed) centres in terms of personnel, work conditions and environment. Moreover, screening in mobile units may require ongoing calibration of instruments, and where analogue units are used, films cannot be developed onsite. These differences could have an impact on screening outcomes but there are few studies comparing the performance of mobile units to fixed sites. 10,11 These studies focussed primarily on comparing costs and other elements (price, access, quality assurance). In some studies, screening results for mobile units were reported but were not compared to fixed centres. 8,[12][13][14] The aims of this study were to evaluate the contribution of mobile mammography units to participation rate, and to compare screening performance between mobile units and fixed centres in the organized mammography screening program of Quebec, Canada. METHODS Population and dataAll eligible women residing in the province, aged 50-69 years, are invited to participate in the Quebec breast cancer screening program. Each participant is asked to sign a written consent form to allow the collection of personal characteristics and screening information. Over the study period, 98% of participants provided written consent. ABSTRACT BACKGROUND: The aims of this study were to evaluate the contribution of mobile mammography units to participation rate and to compare their performance to fixed screening centres within the organized mammography screening program of Quebec, Canada.

Mobile Screening Units for the Early Detection of Cancer: A Systematic Review

“…The quantitative descriptive studies (n ¼ 22) measured various implementation, clinical and service-related outcomes, and generally explicitly or implicitly stated the objective of evaluating the performance of the MSU program. The nonrandomized observational studies (n ¼ 7) sought to answer more specific questions, often with respect to comparisons in screening modalities such as the effectiveness of MSU as compared with fixed clinic screening (13)(14)(15)(16); breast cancer studies comparing digital to film-screen mammography (17,18); cervical cancer studies comparing conventional Pap cytology with liquid-based Pap cytology (Pap-LBC) tests (19,20) or human papillomavirus (HPV) testing with Pap-LBC (21). Two RCTs for mammography screening sought to establish evidence of mortality reductions associated with screening (22,23).…”

Enhancing access to cervical and colorectal cancer screening for women in rural and remote northern Alberta: a pilot study

“…Mobile services have been effective in delivering preventive services such as breast 13,14 and cervical 15 cancer screening, as well as in delivering both of these types of screening together with immunizations. 16 Given 0 that cancer screening guidelines present some overlap in age eligibility for cervical, breast and colorectal cancer [8][9][10] it makes sense to integrate the provision of these 3 types of screening to increase participation.…”

Comparison of Mammography in Combination with Breast Ultrasonography Versus Mammography Alone for Breast Cancer Screening in Asymptomatic Women

“…Providing mobile mammography services with community organizations, can be effective in increasing access and decreasing barriers to screening hard-to-reach populations. On-site mammography at community-based sites where women gather is an effective method for increasing breast cancer screening rates among underserved women (Brooks et al, 2013;Fontenoy et al, 2013). In our institute, National Cancer Institute, we have mobile mammography service team which includes advanced practice staffs, workers and technical support staffs.…”