Screening for breast cancer in nijmegen. report of 6 screening rounds, 1975–1986

Abstract

A population-based screening programme for breast cancer was initiated in Nijmegen in 1975 with mammography as the only screening procedure. Up to January 1987, 6 screening rounds were carried out with a 2-year screening interval. Rates of attendance, referral, biopsy and detection were calculated and numbers of interval cancers are presented in order to give a clear view of what repeated screening can accomplish in a population. At the first screening round the attendance rate was 87% for women under age 50 and 83% for women aged 50-64. For women aged 65 or over the initial attendance rate was 40%. Rates of attendance declined in subsequent years. Detection rates were highest for elderly women at their first examination: 9.5 per 1,000 screened women. Corresponding rates were 5.6 and 2.3 per 1,000 for women aged 50-64 and below 50 respectively. The positive predictive value for referral was, on average, 20% for women under age 50 and 50% for elderly women, although a sharp increase was seen in the last 2 screening examinations for all age-groups. Predictive values for biopsy were higher: 30% on average for women aged under 50 and 60%-70% for elderly women, again with a sharp increase in the last 2 screening rounds. Interval cancer rates, calculated as the number of cancers occurring within 2 years among negatively screened women at risk, showed no particular trend and varied between 0.9-1.3 per 1,000 woman-years after each screening round. Compared to screen-detected cancers, interval cancers occurred more frequently in younger women. In women under age 50, the ratio between screen-detected and interval cancer was about 1:1, while it was about 2:1 for elderly women.

Tc‐99m Sestamibi Scintimammography for the Evaluation of Breast Masses in Patients with Radiographically Dense Breasts

“…The women participating in the current study were relatively young (mean 44.4 ± 8.6 years). The sensitivity of mammography in this study (73.9%) is within the 60–80% range of other reported series in women under 50 years old (8–10). This sensitivity, however, is considerably less than the sensitivity of MIBI, which was 95.6%.…”

“…In addition, mammography misses approximately 10% of clinically detected breast cancers (6) and an even higher number of smaller clinically occult cancers, with this figure reported to be as high as 45% in one series (7). The sensitivity of mammography is lower in younger women (60–84%) compared to older women (86–95%) (8–10).…”

Correcting for Non-Compliance Bias in Case–Control Studies to Evaluate Cancer Screening Programmes

“…Aside from the case-control approach in Section 3.1 and the simple prospective analysis in Section 3.2, there are numerous other possible strategies in the evaluation of service screening programmes (Day et al, 1995;Paci et al, 1995;Peeters et al, 1989;Sasieni and Adams, 2000;Törnberg et al, 1994). The attraction of the case-control approach is that it uses real mortality and it requires relatively little time to perform.…”

Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent.

“…Peeters et al (12) reported a sensi tivity of 93% and a specificity of 99% for mammography in a breast screen ing study. Baker (1) reported a multi center study in which 90% of all m a lignant lesions were detected in a screening population.…”