Introduction of organised mammography screening in Tyrol: results following first year of complete rollout

BMC Public Health

Research Article

Sabine Geiger-Gritsch¹  Willi Oberaigner²  Martin Daniaux³  Rudolf Knapp⁴  Wolfgang Buchberger⁵  Uwe Siebert⁶ 

[1] Department of Clinical Epidemiology of the Tyrolean State Hospitals Ltd., Cancer Registry of Tyrol, Innsbruck, Austria;Department of Clinical Epidemiology of the Tyrolean State Hospitals Ltd., Cancer Registry of Tyrol, Innsbruck, Austria;Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall, i.T., Austria;ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria;Department of Radiology, Innsbruck Medical University, Innsbruck, Austria;Department of Radiology, Kufstein County Hospital, Kufstein, Austria;Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall, i.T., Austria;Medical Department, Tyrolean State Hospitals Ltd., Innsbruck, Austria;Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall, i.T., Austria;ONCOTYROL - Center for Personalized Cancer Medicine, Innsbruck, Austria;Department of Health Policy and Management, Harvard School of Public Health, Center for Health Decision Science, Boston, MA, USA;Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;

关键词: Mammography Screening;    Interval Cancer;    Pilot Phase;    Tyrol;    Double Reading;   

DOI  :  10.1186/1471-2458-11-673

 received in 2011-05-20, accepted in 2011-08-30,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundIn Tyrol, Austria, the existing system of spontaneous mammography screening was switched in 2007 to an organised program by smoothly changing the established framework. This process followed most EU recommendations for organised mammography screening with the following exceptions: women aged 40-49 are part of the target population, screening is offered annually to the age group 40-59, breast ultrasound is available as an additional diagnostic tool, and double reading has not yet been implemented. After a pilot phase the program was rolled out to all of Tyrol in June 2008. The aim of this study was to analyse the performance of the organised screening system by comparing quality indices and recommended levels given in the well-established EU guidelines.MethodsWorking from the results of the pilot phase, we extended the organised mammography system to all counties in Tyrol. All women living in Tyrol and covered by compulsory social insurance were invited for a mammography, in the age group 40-59 annually and in the age group 60-69 biennially. Screening mammography was offered mainly by radiologists in private practice, with further assessment performed at hospitals. Using the screening database, all well-established performance indicators were analysed and compared with accepted/desired levels as per the EU guidelines.ResultsFrom June 2008 to May 2009, 120,440 women were invited. Per 1000 mammograms, 14 women were recalled for further assessment, nine underwent biopsy and four cancer cases were detected. Of invasive breast cancer cases, 32.3% and 68.4% were ≤ 10 mm and ≤ 15 mm in size, respectively, and 79.2% were node-negative. The positive predictive value for further assessment and for biopsy was 25.9% and 39.9%, respectively. Estimated two-year participation rate was 57.0%. In total, 14 interval cancer cases were detected during one year of follow-up; this is 18.4% of the background incidence rate.ConclusionsIn Tyrol, Austria, an organised mammography screening program was implemented in a smooth transition from an existing spontaneous screening system and was completely rolled out within a short time. The high level of performance already seen in the pilot phase was maintained after rollout, and improvements resulting from the pilot phase were affirmed after one year of complete rollout.

【 授权许可】

CC BY   
© Oberaigner et al; licensee BioMed Central Ltd. 2011