Scheduling mammography screening for the early detection of breast cancer in Korean women

Abstract

Objective To propose an efficient screening schedule for breast cancer among Korean women using the stochastic model in which the age-specific incidence rate was considered. Setting Female breast cancer data in the Korea Central Cancer Registry 2002. Methods The stochastic model was based on the threshold method, in which the schedule is determined by a pre-specified threshold value. The threshold value was defined as the probability of being in a preclinical state of breast cancer at age 40 years. The sensitivity of the mammography was specified as 0.7. Two models for mean sojourn time (MST) in the preclinical state were considered; MSTs for Model I were 2 (ageso50 years), 3 (ages 50-59 years), and 4 years (ages X60 years), and MSTs for Model II were 3, 4, and 5 years for the corresponding age groups. Results The threshold method for Model I generated 19 examinations within the screening ages of 40-69 years. Each screening time was determined at ages 40.0, 41.6, 43.2, 44.8, 46.0, 47.2, 48.4, 49.6, 50.7, 51.7, 52.7, 53.7, 54.7, 56.2, 57.8, 59.4, 61.3, 63.1, and 64.9 years. The schedule sensitivity of Model I was 64.2%, which was higher than that (57.5%) of the biennial periodic schedule. Model II included 11 screenings between the ages of 40 and 69 years and also showed a higher schedule sensitivity, especially for women aged 40 years as compared with the biennial screening. Conclusions This finding suggests that the threshold screening schedule for breast cancer increase the schedule sensitivity by reflecting the age-specific incidence rate of a population.

Clinicopathological Characteristics of Mucinous Carcinoma of the Breast in Korea: Comparison with Invasive Ductal Carcinoma-Not Otherwise Specified

“…Screening mammography and use of ultrasonography play an important role in detection of breast cancers in earlier stages (17). Since 1996, it was recommended that all Korean women over 40 yr old underwent a mammography every 1 or 2 yr (18). From 1996 to 2004, the incidence of stage 0 and I breast cancers increased remarkably by 128.6% and 81.6%, respectively (16).…”

Cost‐effective mammography screening in Korea: High incidence of breast cancer in young women

“…Detailed descriptions are provided in our previous study. ( 15 ) Incidence rates were calculated for each age group and ranged from 0 to 4 years of age to more than 85 years of age. The cost estimates of the mammography and the confirmative examination were obtained from the National Health Insurance Corporation of Korea in 2007.…”

“…( 18 ) To estimate the total cost, we defined the unit cost of the mammography, the unit cost of the confirmative tests, and the specificity of the mammography as US$19.50, US$171.90, and 0.95, respectively. ( 15,20 ) To evaluate the robustness of the proposed screening strategies, one‐way sensitivity analyses were conducted by changing the MST in the preclinical state, the sensitivities and the specificities of the mammography, costs, and discount rates. The study parameters are shown in Table 2 with their references.…”

Epidemiology, screening and diagnosis of breast cancer in the Asia–Pacific region: Current perspectives and important considerations

“…Screening programs have been established in Western countries and are being developed around the world, including some Asia–Pacific countries, although there is wide variability in the presence and recommendations of the programs in this region (Table 2). 22,39,40,45–48 In Singapore, population‐based screening was started after a trial program in which 166 600 women aged 50–64 years were randomized to screening by mammography or observation, demonstrated an increase in breast cancer detection from 1.3–4.6 per 1000 women 49 . Through the BreastScreen Singapore program, women aged 40–49 years receive annual mammography while women 50 years of age or older undergo biennial examination at a subsidized rate 38 .…”