Increase in Cancer Detection and Recall Rates with Independent Double Interpretation of Screening Mammography

Harvey, Susan C.; Geller, Berta M.; Oppenheimer, Robert G; Pinet, M.; Riddell, Leslie; Garra, Brian S.

doi:10.2214/ajr.180.5.1801461

Cited by 91 publications

(49 citation statements)

References 25 publications

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“…Differences existed in the use of one-versus two-view mammography, double reading, and the method for arriving at a resolution when double reading led to different assessments. Independent double reading contributes to higher recall rates, 21,34 while consensus double reading is likely to lower them. 19 With this limited number of programs (12 for calculation of initial recall rates and 10 for subsequent recall rates), we were unable to conduct statistical modeling to test for associations of these factors with recall rates.…”

Section: Discussionmentioning

confidence: 99%

International comparison of performance measures for screening mammography: can it be done?

Yankaskas

Ancelle-Park

et al. 2004

J Med Screen

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Objective: Published screening mammography performance measures vary across countries. An international study was undertaken to assess the comparability of two performance measures: the recall rate and positive predictive value (PPV). These measures were selected because they do not require identification of all cancers in the screening population, which is not always possible. Setting:The screening mammography programs or data registries in 25 member countries of the International Breast Cancer Screening Network (IBSN). Methods:In 1999 an assessment form was distributed to IBSN country representatives in order to obtain information on how screening mammography was performed and what specific data related to recall rates and PPV were collected. Participating countries were then asked to provide data to allow calculation of recall rates, PPV and cancer detection rates for screening mammography by age group for women screened in the period 1997-1999.Results: Twenty-two countries completed the assessment form and 14 countries provided performance data. Differences in screening mammography delivery and data collection were evident. For most countries, recall rates were higher for initial than for subsequent mammograms. There was no consistent relationship of initial to subsequent PPV, although PPV generally decreased as the recall rate increased. Recall rates decreased with increasing age, while PPV increased as age increased. Conclusion:Similar patterns for mammography performance measures were evident across countries.However, the development of a more standardized approach to defining and collecting data would allow more valid international comparisons, with the potential to optimize mammography performance. At present, international comparisons of performance should be made with caution due to differences in defining and collecting mammography data.

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Section: Discussionmentioning

confidence: 99%

International comparison of performance measures for screening mammography: can it be done?

Yankaskas

Ancelle-Park

et al. 2004

J Med Screen

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“…However, some facilities carried out double reading during the study time period [14], while others used computer aided detection (CAD), but these represent very few of the total number of mammograms (,20% were either double read or involved CAD use). The initial and final assessments of the screening mammograms were based on the Breast Imaging Reporting and Data Systems (BI-RADS) of the American College of Radiology [15].…”

Section: Screening Mammography In Vermontmentioning

confidence: 99%

Sensitivity and specificity of mammographic screening as practised in Vermont and Norway

Hofvind¹,

Geller²,

Skelly³

et al. 2012

BJR

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Objective: The aim of this study was to examine the sensitivity and specificity of screening mammography as performed in Vermont, USA, and Norway. Methods: Incident screening data from 1997 to 2003 for female patients aged 50-69 years from the Vermont Breast Cancer Surveillance System (116 996 subsequent screening examinations) and the Norwegian Breast Cancer Screening Program (360 872 subsequent screening examinations) were compared. Sensitivity and specificity estimates for the initial (based on screening mammogram only) and final (screening mammogram plus any further diagnostic imaging) interpretations were directly adjusted for age using 5-year age intervals for the combined Vermont and Norway population, and computed for 1 and 2 years of follow-up, which ended at the time of the next screening mammogram. Results: For the 1-year follow-up, sensitivities for initial assessments were 82.0%, 88.2% and 92.5% for 1-, 2-and .2-year screening intervals, respectively, in Vermont (p50.022). For final assessments, the values were 73.6%, 83.3% and 81.2% (p50.047), respectively. For Norway, sensitivities for initial assessments were 91.0% and 91.3% (p50.529) for 2-and .2-year intervals, and 90.7% and 91.3%, respectively, for final assessments (p50.630). Specificity was lower in Vermont than in Norway for each screening interval and for all screening intervals combined, for both initial (90.6% vs 97.8% for all intervals; p,0.001) and final (98.8% vs 99.5% for all intervals; p,0.001) assessments. Conclusion: Our study showed higher sensitivity and specificity in a biennial screening programme with an independent double reading than in a predominantly annual screening program with a single reading. Advances in knowledge: This study demonstrates that higher recall rates and lower specificity are not always associated with higher sensitivity of screening mammography. Differences in the screening processes in Norway and Vermont suggest potential areas for improvement in the latter.

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“…Studies show conflicting results regarding the influence of volume on the sensitivity of cancer detection by reading procedure. 25,26 The recall rate and the positive predictive value are two other performance measures that should be taken into account when analysing the ICR. The US is known to have recall rates that are two to three times higher than those observed in Europe.…”

Section: Reading Proceduresmentioning

confidence: 99%

Comparing Interval Breast Cancer Rates in Norway and North Carolina: Results and Challenges

et al. 2009

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Objective To compare interval breast cancer rates (ICR) between a biennial organized screening programme in Norway and annual opportunistic screening in North Carolina (NC) for different conceptualizations of interval cancer. Setting Two regions with different screening practices and performance. Methods 620,145 subsequent screens (1996–2002) performed in women aged 50–69 and 1280 interval cancers were analysed. Various definitions and quantification methods for interval cancers were compared. Results ICR for one year follow-up were lower in Norway compared with NC both when the rate was based on all screens (0.54 versus 1.29 per 1000 screens), negative final assessments (0.54 versus 1.29 per 1000 screens), and negative screening assessments (0.53 versus 1.28 per 1000 screens). The rate of ductal carcinoma in situ was significantly lower in Norway than in NC for cases diagnosed in both the first and second year after screening. The distributions of histopathological tumour size and lymph node involvement in invasive cases did not differ between the two regions for interval cancers diagnosed during the first year after screening. In contrast, in the second year after screening, tumour characteristics remained stable in Norway but became prognostically more favorable in NC. Conclusion Even when applying a common set of definitions of interval cancer, the ICR was lower in Norway than in NC. Different definitions of interval cancer did not influence the ICR within Norway or NC. Organization of screening and screening performance might be major contributors to the differences in ICR between Norway and NC.

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Increase in Cancer Detection and Recall Rates with Independent Double Interpretation of Screening Mammography

Abstract: The relative increase in cancer detection as a result of the second reviewer is 6.3%, similar to the 5-15% reported in the literature. All but one of the nine additional cancers detected were in the early stages.

Cited by 91 publications

References 25 publications

International comparison of performance measures for screening mammography: can it be done?

International comparison of performance measures for screening mammography: can it be done?

Sensitivity and specificity of mammographic screening as practised in Vermont and Norway

Comparing Interval Breast Cancer Rates in Norway and North Carolina: Results and Challenges

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