Quality of mammography screening in the Milan programme: Evidence of improved sensitivity based on interval cancer proportional incidence and radiological review |
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| Authors: | Pirola Maria Elena Houssami Nehmat Maltagliati Ermes Ceresa Piera Quattrocchi Maria Marinoni Guia Caimi Francesco Villa Roberto Falda Giovanni Gaffuri Isabella Ciatto Stefano |
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| Affiliation: | aAzienda Sanitaria Locale Provincia Milano 1, Italy;bISPO – Istituto per lo Studio e la Prevenzione Oncologica, Viale A. Volta 171, 50133 Firenze, Italy;cScreening and Test Evaluation Program, School of Public Health, Faculty of Medicine, University of Sydney, Sydney, Australia;dAzienda Ospedaliera Spedali Civili, Legnano, Italy;eAzienda Ospedaliera G. Salvini, Garbagnate M., Italy;fClinica San Carlo, Paderno Dugnano, Italy |
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| Abstract: | BackgroundInterval cancer (IC) incidence and review-based initial evaluation of Milan service screening (ASLMI1) suggested suboptimal performance. We report results in a subsequent screening round to further determine screening quality.MethodsIC was identified in subjects with a negative screening episode in 2005 (N = 33,258) by linkage with 2005–2007 Hospital Discharge Records. IC proportional incidence-based sensitivity was estimated. Radiological review, with case-mix, was conducted in a blinded manner. Linkage and review modalities were maintained as for initial evaluation.Results30 identified IC accounted for 6.99% (year 1), 27.84% (year 2), and overall 17.44% (2-year screening interval) proportional incidence. Estimated sensitivity was 93.01% (year 1), 72.16% (year 2) and 82.55% (2-year interval). Review classified 5 (16.6%) as screening error, 2 (6.7%) as minimal signs, and 23 (76.7%) as occult.ConclusionProgramme sensitivity is now within recommended European standards. Performance indicators improved relative to initial evaluation. Both increasing experience and formal training of radiologists are likely to have contributed to this improvement |
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| Keywords: | Breast cancer Population screening Interval cancer Radiological review |
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