Variation in performance in low-volume mammography screening programmes: experience from Switzerland.
Details
State: Public
Version: Author's accepted manuscript
Serval ID
serval:BIB_FEC1CC163EF0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Variation in performance in low-volume mammography screening programmes: experience from Switzerland.
Journal
Cancer Epidemiology
ISSN
1877-7821
ISSN-L
1877-7821
Publication state
Published
Issued date
2011
Peer-reviewed
Oui
Volume
35
Number
3
Pages
293-297
Language
english
Abstract
BACKGROUND: Reading volume and mammography screening performance appear positively correlated. Quality and effectiveness were compared across low-volume screening programmes targeting relatively small populations and operating under the same decentralised healthcare system. Except for accreditation of 2nd readers (restrictive vs non-restrictive strategy), these organised programmes had similar screening regimen/procedures and duration, which maximises comparability. Variation in performance and its determinants were explored in order to improve mammography practice and optimise screening performance. METHODS: Circa 200,000 screens performed between 1999 and 2006 (4 rounds) in 3 longest standing Swiss cantonal programmes (of Vaud, Geneva and Valais) were assessed. Indicators of quality and effectiveness were assessed according to European standards. Interval cancers were identified through linkage with cancer registries records. RESULTS: Swiss programmes met most European standards of performance with a substantial, favourable cancer stage shift. Up to a two-fold variation occurred for several performance indicators. In subsequent rounds, compared with programmes (Vaud and Geneva) that applied a restrictive selection strategy for 2nd readers, 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. CONCLUSION: Differences in performance could partly be explained by a selective strategy for second 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 programmes.
Pubmed
Web of science
Open Access
Yes
Create date
29/11/2010 16:42
Last modification date
20/08/2019 17:29