278 POSTER Assessing the impact of the NHS breast screening program

Purpose: Although some studies have shown increasing radiologists’ mammography volumes improves performance, there is a lack of evidence specific to digital mammography and breast screening program performance targets. This study evaluates the relationship between digital screening volume and meeting performance targets. Methods: This retrospective cohort study included 493 radiologists in the Ontario Breast Screening Program who interpreted 1,762,173 screening mammograms in participants ages 50-90 between 2014 and 2016. Associations between annual screening volume and meeting performance targets for abnormal call rate, positive predictive value (PPV), invasive cancer detection rate (CDR), sensitivity, and specificity were modeled using mixed-effects multivariate logistic regression. Results: Most radiologists read 500-999 (36.7%) or 1,000-1,999 (31.0%) screens annually, and 18.5% read ≥2,000. Radiologists who read ≥2,000 annually were more likely to meet abnormal call rate (OR = 3.85; 95% CI: 1.17-12.61), PPV (OR = 5.36; 95% CI: 2.53-11.34), invasive CDR (OR = 4.14; 95% CI: 1.50-11.46), and specificity (OR = 4.07; 95% CI: 1.89-8.79) targets versus those who read 100-499 screens. Radiologists reading 1,000-1,999 screens annually were more likely to meet PPV (OR = 2.32; 95% CI: 1.22-4.40), invasive CDR (OR = 3.36; 95% CI: 1.49-7.59) and specificity (OR = 2.00; 95% CI: 1.04-3.84) targets versus those who read 100-499 screens. No significant differences were observed for sensitivity. Conclusions: Annual reading volume requirements of 1,000 in Canada are supported as screening volume above 1,000 was strongly associated with achieving performance targets for nearly all measures. Increasing the minimum volume to 2,000 may further reduce the potential limitations of screening due to false positives, leading to improvements in overall breast screening program quality.

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Hindsight is 2020: Understanding the Impact of the COVID-19 Pandemic on a Provincial Population-Based Breast Screening Program

Canadian Association of Radiologists Journal ◽

10.1177/08465371211036902 ◽

2021 ◽

pp. 084653712110369

Author(s):

Helena Bentley ◽

Ryan Woods ◽

Colin Mar ◽

Terry Tang ◽

Nivedha Raveinthiranathan ◽

...

Keyword(s):

Breast Screening ◽

Screening Program ◽

Population Based ◽

The Impact

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National Colorectal Cancer Screening Program in Lithuania: Description of the 5-Year Performance on Population Level

Cancers ◽

10.3390/cancers13051129 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1129

Author(s):

Audrius Dulskas ◽

Tomas Poskus ◽

Inga Kildusiene ◽

Ausvydas Patasius ◽

Rokas Stulpinas ◽

...

Keyword(s):

Colorectal Cancer ◽

Quality Assurance ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Screening Program ◽

Histopathological Examination ◽

Insurance Fund ◽

Crc Screening ◽

Cancer Screening Program ◽

The Impact

We aimed to report the results of the implementation of the National Colorectal Cancer (CRC) Screening Program covering all the country. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the program has its own administrative code. Information about services provided within the program was retrieved from the database of NHIF starting from the 1 January 2014 to the 31 December 2018. Exact date and type of all provided services, test results, date and results of biopsy and histopathological examination were extracted together with the vital status at the end of follow-up, date of death and date of emigration when applicable for all men and women born between 1935 and 1968. Results were compared with the guidelines of the European Union for quality assurance in CRC screening and diagnosis. The screening uptake was 49.5% (754,061 patients) during study period. Participation rate varied from 16% to 18.1% per year and was higher among women than among men. Proportion of test-positive and test-negative results was similar during all the study period—8.7% and 91.3% annually. Between 9.2% and 13.5% of test-positive patients received a biopsy of which 52.3–61.8% were positive for colorectal adenoma and 4.6–7.3% for colorectal carcinoma. CRC detection rate among test-positive individuals varied between 0.93% and 1.28%. The colorectal cancer screening program in Lithuania coverage must be improved. A screening database is needed to systematically evaluate the impact and performance of the national CRC screening program and quality assurance within the program.

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Screening for Melanoma and Other Skin Cancer Shows a Higher Early Melanoma Incidence: Social Educational Program “Life Fear-Free”

Dermatopathology ◽

10.3390/dermatopathology8010011 ◽

2021 ◽

Vol 8 (1) ◽

pp. 54-68

Author(s):

Lev Demidov ◽

Igor Samoylenko ◽

Nina Vand ◽

Igor Utyashev ◽

Irina Shubina ◽

...

Keyword(s):

Skin Cancer ◽

Screening Program ◽

Excisional Biopsy ◽

Skin Lesions ◽

Detection Methods ◽

Non Melanoma Skin Cancer ◽

The Social ◽

Educational Campaign ◽

Skin Cancer Detection ◽

The Impact

Background: The screening program Life Fear-Free (LFF) aimed at early diagnosis of cutaneous melanoma (CM) was introduced in Samara, Chelyabinsk, Yekaterinburg, and Krasnodar (Russia) in 2019. Objectives: To analyze the impact of the program on early CM and non-melanoma skin cancer (NMSC) detection. Methods: According to the social educational campaign, people were informed about CM risk factors and symptoms and were invited for skin examination. The program planned to involve 3200 participants in total. Participants with suspicious lesions were invited for excisional biopsy. Results: 3143 participants, including 75.4% women, were examined for skin lesions. The average age of the participants was 43.7 years. Mostly skin phototypes II and III were registered (48.2% and 41.0%, respectively); 3 patients had CM, 15 had basal cell carcinoma, and 1 had Bowen’s disease, which were confirmed histologically. All detected melanomas had Breslow’s thickness of 1 mm. Conclusion: The participants showed high interest in early skin cancer detection programs. The incidence rate of CM and NMSCs among the program participants was higher than in general public. The early disease grade was proven for the detected CMs and NMSCs. The study has shown that it is important to continue such programs.

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Performance of Unobserved Self-Collected Nasal Swabs for Detection of SARS-CoV-2 by RT-PCR Utilizing a Remote Specimen Collection Strategy

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab039 ◽

2021 ◽

Author(s):

Ron M Kagan ◽

Amy A Rogers ◽

Gwynngelle A Borillo ◽

Nigel J Clarke ◽

Elizabeth M Marlowe

Keyword(s):

Return To Work ◽

Screening Program ◽

False Negative ◽

N Gene ◽

Rt Pcr ◽

Pooled Testing ◽

Specimen Collection ◽

Asymptomatic Patients ◽

Nasal Swabs ◽

The Impact

Abstract Background The use of a remote specimen collection strategy employing a kit designed for unobserved self-collection for SARS-CoV-2 RT-PCR can decrease the use of PPE and exposure risk. To assess the impact of unobserved specimen self-collection on test performance, we examined results from a SARS-CoV-2 qualitative RT-PCR test for self-collected specimens from participants in a return-to-work screening program and assessed the impact of a pooled testing strategy in this cohort. Methods Self-collected anterior nasal swabs from employee return to work programs were tested using the Quest Diagnostics SARS-CoV-2 RT-PCR EUA. The Ct values for the N1 and N3 N-gene targets and a human RNase P (RP) gene control target were tabulated. For comparison, we utilized Ct values from a cohort of HCP-collected specimens from patients with and without COVID-19 symptoms. Results Among 47,923 participants, 1.8% were positive. RP failed to amplify for 13/115,435 (0.011%) specimens. The median (IQR) Cts were 32.7 (25.0-35.7) for N1 and 31.3 (23.8-34.2) for N3. Median Ct values in the self-collected cohort were significantly higher than those of symptomatic, but not asymptomatic patients. Based on Ct values, pooled testing with 4 specimens would have yielded inconclusive results in 67/1,268 (5.2%) specimens but only a single false-negative result. Conclusions Unobserved self-collection of nasal swabs provides adequate sampling for SARS-CoV-2 RT-PCR testing. These findings alleviate concerns of increased false negatives in this context. Specimen pooling could be used for this population as the likelihood of false negative results is very low due when using a sensitive, dual-target methodology.

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Abnormal screens among nonmutation carriers in the High Risk Ontario Breast Screening Program

The Breast Journal ◽

10.1111/tbj.14185 ◽

2021 ◽

Author(s):

Matthew Castelo ◽

Zachary Brown ◽

Angela E. Schellenberg ◽

Jane K. Mills ◽

Andrea Eisen ◽

...

Keyword(s):

High Risk ◽

Breast Screening ◽

Screening Program

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Interval Breast Cancers in the NHS Breast Screening Programme: Does the Current Definition Exclude Too Many?

Journal of Medical Screening ◽

10.1177/096914139700400310 ◽

1997 ◽

Vol 4 (3) ◽

pp. 169-173 ◽

Cited By ~ 11

Author(s):

A M Faux ◽

D C Richardson ◽

G M Lawrence ◽

M E Wheaton ◽

M G Wallisconsultant

Keyword(s):

Breast Screening ◽

Interval Cancer ◽

Breast Cancers ◽

Interval Cancers ◽

Exclusion Criteria ◽

National Statistics ◽

Screening Unit ◽

Cancer Rates ◽

Definition Of ◽

The Impact

Objectives— To examine the impact of the definition of interval breast cancers on interval cancer rates arising from the prevalent (first) screening round. Design— Interval breast cancers arising from the prevalent (first) screening round at the Warwickshire, Solihull and Coventry Breast Screening Unit (17 April 1989 to 31 March 1992) were identified by comparison of data held at the unit with records at the West Midlands Cancer Intelligence Unit. Exclusion criteria used in National statistics were applied to this sample to quantify their impact on achieved interval cancer rates. The round lengths experienced by individual women at the unit were determined from the prevalent and incident invitation dates for 155 women with incident (re-screen) breast cancers detected in the second round. Setting— Warwickshire, Solihull and Coventry Breast Screening Unit. Subects—59 017 women screened between 17 April 1989 and 31 March 1992 with a negative screening result and 155 women with incident screen detected cancers. Results— A total of 278 interval cancers were identified, giving an overall rate from the prevalent screening round of 47.1/10 000 women screened. Of these, 213 met the criteria used in the definition of interval cancers for National statistics and were termed “core” interval cancers. The overall “core” interval rate was 36.1/10 000 women screened, similar to interval cancer rates found in the north west of United Kingdom. Thus applying commonly used exclusion criteria produced a 23.4% reduction in the apparent interval cancer rate, with the largest decrease resulting from the exclusion of cancers arising at 36 months or more from the last screen. Conclusions— The exclusion criteria used in the definition of interval cancers have a significant impact on observed interval cancer rates. Of particular concern is the exclusion in the current National definitions of cancers arising at 36 months or more from the last screen, which may mask a problem with significant implications for the success of the NHSBSP.

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