Variation in performance across Swiss mammography screening programmes: the influence of reading strategy and experience.

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Serval ID
serval:BIB_804C0E4323AF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Variation in performance across Swiss mammography screening programmes: the influence of reading strategy and experience.
Journal
Schweizer Krebsbulletin. Bulletin suisse du cancer
Author(s)
Bulliard Jean-Luc, Ducros Cyril, Dayer Eric, Arzel Béatrice, Levi Fabio
Publication state
Published
Issued date
2010
Volume
30
Number
4
Pages
333-338
Language
english
Abstract
[Abstract] Reading volume and mammography screening performance appear positively correlated. Performance was compared across organised Swiss screening programmes, which target relatively small populations. Except for accreditation of 2nd readers radiologists (restrictive vs non-restrictive strategy), Swiss programmes have similar screening regimen/procedures and duration, which maximises comparability. Variation in performance was explored in order to improve mammography practice and optimise screening performance.
Indicators of quality and effectiveness were evaluated for about 200,000 screens performed over 4 screening rounds in the 3 longest-standing Swiss cantonal programmes (of Vaud, Geneva and Valais). Interval cancers were identified by linkage with cancer registries records.
Most European standards of performance were met with a favourable cancer stage shift. Several performance indicators showed substantial variation across programmes. In subsequent rounds, compared with programmes (Vaud and Geneva) which accredited few 2nd readers to increase their individual reading volume, proportions of in situ lesions and of small cancers (? 1cm) were one third lower and halved, respectively, and the proportion of advanced lesions (stage II+) nearly 50% higher in the programme without a restrictive selection strategy. Discrepancy in second-year proportional incidence of interval cancers appears to be multicausal.
Differences in performance could partly be explained by a selective strategy for 2nd readers and a prior experience in service screening, but not by the levels of opportunistic screening and programme attendance. This study provides clues for enhancing mammography screening performance in low-volume Swiss programmes.
Keywords
Mammography/methods , Breast Neoplasms/radiography , Mass Screening , Observer Variation , Switzerland
Create date
08/12/2010 12:20
Last modification date
20/08/2019 15:40
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