Two models for radiological reviewing of interval cancers

Moberg, Kerstin Uvnäs; Grundström, Heléne; Törnberg, Sven; Lundquist, H.; Svane, Gunilla; Havervall, L.; Muren, C.

doi:10.1136/jms.6.1.35

Cited by 45 publications

(25 citation statements)

References 11 publications

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“…The results are also in agreement with the better possibilities to reduce mortality in older women compared with young women (9,10). The definition of an interval cancer varies (1,2,11,12) and is probably the main reason for the relatively high proportion of interval cancers in the last period of the interval compared with the incidence before the screening started. It is very difficult to achieve an exact interval for all the women in the target group, and this ''round slippage'' may be due to several factors, including administrative factors, changes to scheduled appointment etc.…”

Section: Screening and Interval Cancerssupporting

confidence: 82%

Do the results of the process indicators in the Norwegian breast cancer screening program predict future mortality reduction from breast cancer?

2004

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Section: Screening and Interval Cancerssupporting

confidence: 82%

Do the results of the process indicators in the Norwegian breast cancer screening program predict future mortality reduction from breast cancer?

2004

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“…14 -17 However, immediate comparison of frequencies must be done with caution because of differences in inclusion criteria and screening protocol. 18,19 Early assessment after an unclear screening result is discouraged in the Norwegian Breast Cancer Screening Program's quality manual. Women who [15][16][17] However, when the interval was split in 2 periods, comparison of observed/expected ratios revealed that whereas our rate in the first year was in accordance with the reported proportionate incidences, our estimate of the second year (0.75) was higher than the corresponding figures from other programs (0.59 in East Anglia, 14 0.52 in Holland, 15 0.52 in North West England 16 and 0.54 in Victoria, Australia 17 ).…”

Section: Frequency Of Invasive Interval Cancersmentioning

confidence: 99%

Interval cancers in the Norwegian breast cancer screening program: Frequency, characteristics and use of HRT

et al. 2001

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Key words: mammography screening; interval cancer; breast density; HRTAs a result of the mortality reduction found in several randomized controlled clinical trials, 1,2 breast cancer screening programs have been implemented in several western countries. 3 The Norwegian Breast Cancer Screening Program is a population-based program that offers women aged 50 -69 years biannual mammography screening. The program started as a pilot project in 4 counties in 1996, and the results from the first screening round were reported earlier. 4 Interval cancers can be defined as breast cancer diagnosed in screened women during the interval between 2 screening rounds, where the diagnosis does not follow from the screening examination. 5 The benefit of attending a screening program is reduced for women diagnosed with interval cancer. Thus the effect of a screening program in terms of mortality reduction can diminish if the frequency of interval cancer is high. This frequency depends, among other factors, on sensitivity of the test and length of the screening interval.Most interval cancers are diagnosed because of symptoms, hence interval and screening-detected cancers might be expected to have different characteristics. High breast density and use of hormone replacement therapy (HRT) have been discussed as possible contributors to reduction of screening sensitivity, and this may be related to occurrence of interval cancers. 6 -11 The purpose of our study was to quantify the interval cancers in the pilot project and to explore characteristics and factors that may be associated with interval cancer. To study the relations between use of HRT, breast density and interval cancer, data from a blinded review (breast density) and a questionnaire (use of HRT) were linked. MATERIAL AND METHODS Screening populationThe Norwegian Breast Cancer Screening Program is population based and covers women aged 50 -69 years. The screening population is identified through the Central Population Register, in which each inhabitant in Norway has a unique 11-digit number. Women are invited into the Norwegian Breast Cancer Screening Program irrespective of previous breast cancer history. The screening interval is 2 years. Two-view mammograms and independent double reading are standard. The pilot project included 4 counties with about 40% of the Norwegian female population aged 50 -69 years. During the first round (1996-97), 159,887 women born from 1927-46 were invited and 127,064 women were examined (79.5%). 4 Study subjectsWomen who had their first screening examination within the pilot project after July 31, 1998 (n ϭ 411) and women who experienced recurrence in the same breast as a previous lesion (n ϭ 6) were excluded from the study. Women who received a cancer diagnosis in the first screening round (n ϭ 854) were not included as being at risk of interval cancer. However, women who were screen-positive but cleared after assessment were included. This left 125,793 women at risk of developing interval cancer. The women were followed until the date an in...

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“…The European guidelines (Perry et al, 2006) recommend screening units to monitor IC for purposes of internal audit and training. In screening programmes performing double reading with trained radiologists, only a small proportion of the IC are classified as interpretation errors (missed) (Moberg et al, 1999;Hofvind et al, 2006). In other instances they represent a limit of the test (occult or showing nonspecific mammographic signs) or arise in the screening interval; the longer the interval, the greater the risk of IC (Woodman et al, 1995;Klemi et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

A pooled analysis of interval cancer rates in six European countries

Törnberg

Kemetli

Ascunce

et al. 2010

European Journal of Cancer Prevention

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The objective of this study was to assess detection rates and interval breast cancer (IC) rates from eight programmes in the European Breast Cancer Screening Network. A common data collection protocol was used to explore differences in IC rates among programmes and discuss their potential determinants. Pooled analysis was used to describe IC rates by age, compliance in screening, recall rate, screening detection (SD) rate and expected breast cancer incidence. Participation in screening averaged 77.9% (range 42.6-88.7%), recall rate 5.4% (range 3.3-17.7%) in the initial and 3.4% (range 1.8-8.9%) in the subsequent screening rounds, and SD rate was 60.4 (range 41.6-91) per 10 000 women in initial and 38.5 (range 31.3-62.6) in subsequent screens. IC rate during first 12 months after screening was 5.9 (range 2.1-7.3) per 10 000 women screened negative and 12.6 (range 6.3-15) in the second year of the interval. IC comprised 28% of the IC and SD cancers. The ratio between IC rate and expected incidence was 0.29 for the first 12 months and 0.63 for the 13-24 months period. Sensitivity was higher for the ages 60-69 years and for initial tests than subsequent tests. There were distinct differences in the IC rates between programmes. The results of this study reveal large variations in screening sensitivity and performance. Pooled evaluation of some process indicators within the European breast cancer screening programmes proved to be feasible and is likely to be useful for the future, particularly if it is performed regularly and extensively.

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Two models for radiological reviewing of interval cancers

Cited by 45 publications

References 11 publications

Do the results of the process indicators in the Norwegian breast cancer screening program predict future mortality reduction from breast cancer?

Do the results of the process indicators in the Norwegian breast cancer screening program predict future mortality reduction from breast cancer?

Interval cancers in the Norwegian breast cancer screening program: Frequency, characteristics and use of HRT

A pooled analysis of interval cancer rates in six European countries

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