Flemish breast cancer screening programme: 15 years of key performance indicators (2002–2016)

Goossens, Herman; Brabander, Isabel De; Grève, Jacques De; Ongeval, Chantal Van; Martens, Patrick; Limbergen, Erik; Kellen, Eliane

doi:10.1186/s12885-019-6230-z

Cited by 16 publications

(18 citation statements)

References 20 publications

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“…Municipality level screening coverage in 2008–2016 was calculated using data from the Center for Cancer Detection in Flanders [ 25 ]. Municipalities that have no missing values of the number of screened and non-screened women were included in the study.…”

Section: Methodsmentioning

confidence: 99%

Coverage determinants of breast cancer screening in Flanders: an evaluation of the past decade

Ding

Jidkova

Greuter

et al. 2020

Int J Equity Health

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Background Breast cancer (BC) is the most common cancer in women in the developed world. In order to find developing cancers in an early stage, BC screening is commonly used. In Flanders, screening is performed in and outside an organized breast cancer screening program (BCSP). However, the determinants of BC screening coverage for both screening strategies are yet unknown. Objective To assess the determinants of BC screening coverage in Flanders. Methods Reimbursement data were used to attribute a screening status to each woman in the target population for the years 2008–2016. Yearly coverage data were categorized as screening inside or outside BCSP or no screening. Data were clustered by municipality level. A generalized linear equation model was used to assess the determinants of screening type. Results Over all years and municipalities, the median screening coverage rate inside and outside BCSP was 48.40% (IQR: 41.50–54.40%) and 14.10% (IQR: 9.80–19.80%) respectively. A higher coverage rate outside BSCP was statistically significantly (P < 0.001) associated with more crowded households (OR: 3.797, 95% CI: 3.199–4.508), younger age, higher population densities (OR: 2.528, 95% CI: 2.455–2.606), a lower proportion of unemployed job seekers (OR: 0.641, 95% CI: 0.624–0.658) and lower use of dental care (OR: 0.969, 95% CI: 0.967–0.972). Conclusion Coverage rate of BC screening is not optimal in Flanders. Women with low SES that are characterized by younger age, living in a high population density area, living in crowded households, or having low dental care are less likely to be screened for BC in Flanders. If screened, they are more likely to be screened outside the BCSP.

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Section: Methodsmentioning

confidence: 99%

Coverage determinants of breast cancer screening in Flanders: an evaluation of the past decade

Ding

Jidkova

Greuter

et al. 2020

Int J Equity Health

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“…Where the BCSP is fully reimbursed by health insurance, opportunistic screening does not have a systematic quality control such as daily quality checks of mammography equipment, double reading and case-based feedback to readers (10). Although these two screening strategies coexist in Flanders, the combined coverage rate is only 64.1%, with a coverage rate of 50.0% for the BCSP and 14.1% for the opportunistic screening (11).…”

Section: Screening In Flandersmentioning

confidence: 99%

The Role of Socio-Demographic Factors in the Coverage of Breast Cancer Screening: Insights From a Quantile Regression Analysis

Ding

Jidkova

Greuter

et al. 2021

Front. Public Health

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Background: In Flanders, breast cancer (BC) screening is performed in a population-based breast cancer screening program (BCSP), as well as in an opportunistic setting. Women with different socio-demographic characteristics are not equally covered by BC screening.Objective: To evaluate the role of socio-demographic characteristics on the lowest 10th and highest 90th quantile levels of BC screening coverage.Methods: The 2017 neighborhood-level coverage rates of 8,690 neighborhoods with women aged 50–69 and eligible for BCSP and opportunistic screening were linked to socio-demographic data. The association between socio-demographic characteristics and the coverage rates of BCSP and opportunistic screening was evaluated per quantile of coverage using multivariable quantile regression models, with specific attention to the lowest 10th and highest 90th quantiles.Results: The median coverage in the BCSP was 50%, 33.5% in the 10th quantile, and 64.5% in the 90th quantile. The median coverage of the opportunistic screening was 12, 4.2, and 24.8% in the 10th and 90th quantile, respectively. A lower coverage of BCSP was found in neighborhoods with more foreign residents and larger average household size, which were considered indicators for a lower socioeconomic status (SES). However, a higher average personal annual income, which was considered an indicator for a higher SES, was also found in neighborhoods with lower coverage of BCSP. For these neighborhoods, that have a relatively low and high SES, the negative association between the percentage of foreign residents, average household size, and average personal annual income and the coverage in the BCSP had the smallest regression coefficient and 95% confidence interval (CI) values were −0.75 (95% CI: −0.85, −0.65), −13.59 (95% CI: −15.81, −11.37), and −1.05 (95% CI: −1.18, −0.92), respectively, for the 10th quantile. The neighborhoods with higher coverage of opportunistic screening had a relatively higher average personal annual income, with the largest regression coefficient of 1.72 (95% CI: 1.59, 1.85) for the 90th quantile.Conclusions: Women from relatively low and high SES neighborhoods tend to participate less in the BCSP, whereas women with a relatively high SES tend to participate more in opportunistic screening. For women from low SES neighborhoods, tailored interventions are needed to improve the coverage of BCSP.

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“…In places where there is an organized population screening, women in the age group in question receive an invitation letter to do the mammography, and that is enough for them to undergo the exam. Then, the test result is evaluated by a doctor and they receive a new letter informing the result and already scheduling a new exam for the next round of tests, as recommended in different countries 1,5,15 . In Brazil, despite financial and time-related difficulties existing among the population served at SUS, women must first have a medical prescription for undergoing a mammography, which is usually prescribed by doctors working in Health Units or, eventually, in the Family Health Strategy program, which is a Brazilian program aiming at reorganizing primary healthcare services, promoting the quality of life of the Brazilian population, and preventing factors that pose risk to their health.…”

Section: Discussionmentioning

confidence: 99%

“…In Flanders, Belgium, for women aged between 50 and 69 years, the debureaucratization and change from an opportunistic screening to an organized, biennial screening model increased mammography coverage from 14%, in 2002, to 64%, in 2016 5 . This indicates that such organized and unbureaucratic model may be a good option for the Brazilian public health.…”

Section: Discussionmentioning

confidence: 99%

“…Despite this worldwide discussion, the impossibility of detecting more aggressive tumors, including cases of interval cancer 5 , together with the great difficulty of access to health services that exists in Brazil 6 , certainly makes the model of opportunistic breast cancer screening to not be fully adopted in the country yet, with an effective reduction in mortality, as previously published 7,8 .…”

Section: Introductionmentioning

confidence: 99%

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Opportunistic mammography screening by the Brazilian Unified Health System in 2019

et al. 2020

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Introduction: Mammography screening has been the best method for detecting early tumors and reducing breast cancer mortality according to different studies. In Brazil, the number of women who undergo mammography tests by the Brazilian Unified Health System (SUS) has been far below international recommendations. Objective: To describe the number of mammographies, mammography coverage, and the amount spent on this exam during 2019 by SUS, in Brazil. Method: Ecological study with data from the Department of Informatics of the Brazilian Unified Health System and the Brazilian Institute for Geography and Statistics in order to verify the number of mammographies performed by the SUS concerning the Brazilian female population in Brazil, in the age group of 50 to 69 years, in the states and in macro-regions during 2019. Results: In 2019, 2,660,469 mammographies were performed in the country out of the expected total of 12,154,979, accounting for a 21.9% mammography coverage by SUS at the cost of BRL 117,841,231.97. The lowest coverage rates were verified in the states of Amapá (0.6%) and the Federal District (4.9%), whereas the best rates were found in the states of Paraná (29.7%) and Alagoas (29.6%). Conclusions: The number of mammographies performed in Brazil in 2019 by SUS corresponded to almost ¼ of the country’s need, with mammography coverage far below the target and being widely different among the many Brazilian states

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Flemish breast cancer screening programme: 15 years of key performance indicators (2002–2016)

Cited by 16 publications

References 20 publications

Coverage determinants of breast cancer screening in Flanders: an evaluation of the past decade

Coverage determinants of breast cancer screening in Flanders: an evaluation of the past decade

The Role of Socio-Demographic Factors in the Coverage of Breast Cancer Screening: Insights From a Quantile Regression Analysis

Opportunistic mammography screening by the Brazilian Unified Health System in 2019

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