The outcome of a quality-controlled mammography screening program: Experience from a population-based study in Taiwan

Abstract

From the outcome review of this national mammography screening, there is still room to ameliorate our performance through comprehensive and continued education, to improve the competence of cancer detection and decrease false negative (FN) cases.

Mammography and breast cancer screening

“…1 In Taiwan, the government not only provides Pap smears for cervical cancer screening, but has maintained a nationwide, free and biennial mammographic screening program since 2004. 1 There was a significant 10-year delay from the time that Pap smear screening began to be widely used in Taiwan in 1995. 2,3 Like most medical developments that have to go through routine channels of administrative review, the path to ultimate approval by the Taiwanese government can be challenging.…”

“…6 In addition, Dr. Pan in this issue might have displayed a greater interest in the decreasing of false negative cases instead of false positive screening mammography. 1 However, false positive screening mammography is an important issue not only arising from the considerable increase in financial cost it poses, but also for the emotional cost as well. It has been reported that the financial burden to patients from health care utilization due to unnecessary recall following a screening mammography was significant and disproportionately distributed.…”

Outcome of mammography screening in Taiwan

“…7 Although there has been a significant increase in the workload of both the women being screened and those performing the screening, the quality of the screening is unaffected. It appears that the indicators of recall rate, positive predictive values (PPV1), cancer detection rate, incidence rate, and specificity reach the recommended American College of Radiology levels, except for a slightly lower sensitivity.…”

“…In addition, the sensitivity in 2009 (79.6%) is lower than the average; whether this is a factor influencing the change in cancer detection rate between 2009 and 2010 has not yet been determined. 7 Furthermore, digital mammography has rapidly replaced film mammography in most areas of Taiwan. With the popularity of the digital radiography mammogram system in the screening institutes, this may help improve the cancer detection rate with better resolution and improved interpretation.…”

“…7 In Taiwan, nationwide free mammographic screening for women between the ages of 40 years and 69 years is beneficial in the early detection of breast cancer. This paper provides us with more recent information about the effectiveness of screening mammography in breast cancer detection.…”