State of Alaska Epidemiology Bulletin: Mammography screening in women 40 to 49 years old benefits unproven

1994 ◽  
Keyword(s):  
Mammography Screening

The state of the organised mammography screening in Hungary in 2006

2007 ◽  
Vol 148 (19) ◽  
pp. 879-885 ◽  
Author(s):  
Attila Kovács ◽  
Lajos Döbrőssy ◽  
András Budai ◽  
Imre Boncz ◽  
Ágnes Cornides
Keyword(s):  
Mammography Screening ◽  
The State

Magyarországon az emlőrák jelentős népegészségügyi probléma. A halálozás mérséklésére a tünetmentes asszonyok szervezett, azaz személyes behíváson, visszahíváson és utánkövetésen alapuló szűrővizsgálata a legígéretesebb módszer. A tapintásos emlővizsgálattal kiegészített mammográfiás szűrés az 50–65 éves korcsoportban bizonyítottan hatásos; praemenopausalis asszonyok esetében a hatásosság még nem bizonyított, ennek ellenére a közvélemény és a szakmai döntéshozókra nehezedő nyomás miatt a perimenopausalis korban levő (45 év feletti) asszonyokat nem rekesztik ki a szűrőprogramból. Magyarországon a Nemzeti Népegészségügyi Program megteremtette a szervezett emlőszűrés szervezeti, adminisztratív, jogszabályi és pénzügyi feltételeit, így a szűrőprogram 2002 óta működik. A két szűrési ciklus adatai szerint a szervezett szűrésen a meghívottak mintegy 40%-a vesz részt. Az Országos Egészségbiztosítási Pénztár észrevételei szerint a meghívásos szűrés hatására jelentősen megemelkedett a diagnosztikus mammográfiás vizsgálatok száma; ez arra utal, hogy számosan a szervezett szűrés keretein kívül keresik a szűrés lehetőségét. A szűrővizsgálattal felfedezett emlőrákok száma, ezen belül a kis rákok aránya a nemzetközi standard értékeknek megfelelő. Az ún. intervallumrákok gyakoriságának megállapítására a szűrési nyilvántartással együttműködő patológiai adatbank létesítése folyamatban van. A szervezett emlőszűrés egészség-gazdaságtani elemzés szerint elfogadható a finanszírozó számára.

The “gray zone” in fine-needle aspiration cytology of the organized mammography screening. Cytohistological correlation

2011 ◽  
Vol 152 (8) ◽  
pp. 292-295
Author(s):  
Mihály Bak ◽  
Éva Konyár ◽  
Ferenc Schneider ◽  
Mária Bidlek ◽  
Éva Szabó ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Mammography Screening ◽  
Fine Needle Aspiration Cytology ◽  
Benign Lesion ◽  
Needle Aspiration ◽  
Gray Zone ◽  
Aspiration Cytology ◽  
Surgical Biopsy ◽  
Fine Needle ◽  
Needle Aspiration Cytology

The National Public Health Program has established the organized mammography screening in Hungary. The aim of this study was to conduct an audit of “gray zone” smears of the organized mammography screening in comparison with histopathological diagnoses. Methods: Cytology results were rated to C3 atypia probably benign and C4 suspicious of malignancy. Results: 1361 women had aspiration cytology performed from a total of 47,718 mammography non-negative lesions. 105 (7.8%) were diagnosed as C3, whereas 78 (5.7) as C4. Of the 105 patients with C3 diagnosis 61 (58%) patients underwent surgical biopsy. Histology proved malignancy in 20 (32.8%) cases, and benign lesion in 41 (67.2%) cases. All (100%) of the 78 patients with C4 diagnosis had open biopsies; 69 (88.4%) cases were histologically malignant and 9 (11.6%) cases were benign lesions. Conclusion: The auditing results of fine needle aspiration cytology of “gray zone” in organized mammography screening meet the proposed threshold values. Authors conclude that the “gray zone” category in breast cytology is useful and of value if used judiciously. Orv. Hetil., 2011, 152, 292–295.

Quality assurance of fine-needle aspiration cytology of the organized mammography screening

2010 ◽  
Vol 151 (32) ◽  
pp. 1295-1298 ◽  
Author(s):  
Mihály Bak ◽  
Éva Konyár ◽  
Ferenc Schneider ◽  
Mária Bidlek ◽  
Éva Szabó ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Fine Needle Aspiration ◽  
Mammography Screening ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

A Nemzeti Népegészségügyi Program az emlőrák szervezett szűrését biztosítja. Célkitűzés: Dolgozatunk célja a szervezett emlőrákszűrés során a mammográfia, illetve ultrahangvizsgálatokkal nem negatív elváltozások aspirációs citológiai diagnózisainak minőségbiztosítása. Módszer: A citológiai diagnózisokat 5 kategóriába (C1, C2, C3, C4, C5) soroltuk. A citológiai módszer diagnosztikus érzékenységét a szövettani eredményekhez viszonyítva elemeztük. Eredmények: Összesen 47718 mammográfiás és ultrahangvizsgálattal a kóros emlőelváltozásokból 1361 citológiai vizsgálatot végeztünk. A leggyakoribb diagnózis benignus (805 eset, 59, 1%), illetve carcinoma (187 eset, 13,7%) volt. Az összesített pozitív, negatív esetek számításánál a szenzitivitás 91%, a specificitás 88%, a pozitív prediktív érték 96,6%, a negatív prediktív érték 71%-nak (p<0,001) bizonyult. Megbeszélés: Megállapítottuk, hogy tanulmányunkban az emlőelváltozások vékonytű-aspirációs citológiai vizsgálatainak minőségbiztosítási eredményei megfelelnek, és több tekintetben jobbak a nemzetközileg elvárt követelményeknél.

scholarly journals Telemammography for breast cancer screening: a cost-effective approach in Argentina

2021 ◽  
Vol 28 (1) ◽  
pp. e100351
Author(s):  
Victoria Alba Malek Pascha ◽  
Li Sun ◽  
Ramiro Gilardino ◽  
Rosa Legood
Keyword(s):  
Breast Cancer ◽  
Sensitivity Analysis ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Probabilistic Sensitivity Analysis ◽  
Mammography Screening ◽  
Cost Effective ◽  
Access To Healthcare ◽  
Over 40 Years ◽  
Improve Access

ObjectivesArgentina is a low and middle-income country (LMIC) with a highly fragmented healthcare system that conflicts with access to healthcare stated by the country’s Universal Health Coverage plan. A tele-mammography network could improve access to breast cancer screening decreasing its mortality. This research aims to conduct an economic evaluation of the implementation of a tele-mammography program to improve access to healthcare.MethodsA cost-utility analysis was performed to explore the incremental benefit of annual tele-mammography screening for at-risk Argentinian women over 40 years old. A Markov model was developed to simulate annual mammography or tele-mammography screening in two hypothetical population-based cohorts of asymptomatic women. Parameter uncertainty was evaluated through deterministic and probabilistic sensitivity analysis. Model structure uncertainty was also explored to test the robustness of the results.ResultsIt was estimated that 31 out of 100 new cases of breast cancer would be detected by mammography and 39/100 by tele-mammography. The model returned an incremental cost-effectiveness ratio (ICER) of £26 051/quality-adjusted life-year (QALY) which is lower than the WHO-recommended threshold of £26 288/QALY for Argentina. Deterministic sensitivity analysis showed the ICER is most sensitive to the uptake and sensitivity of the screening tests. Probabilistic sensitivity analysis showed tele-mammography is cost-effective in 59% of simulations.DiscussionTele-mammography should be considered for adoption as it could improve access to expertise in underserved areas where adherence to screening protocols is poor. Disaggregated data by province is needed for a better- informed policy decision. Telemedicine could also be beneficial in ensuring the continuity of care when health systems are under stress like in the current COVID-19 pandemic.ConclusionThere is a 59% chance that tele-mammography is cost-effective compared to mammography for at-risk Argentinian women over 40- years old, and should be adopted to improve access to healthcare in underserved areas of the country.

scholarly journals Psychological predictors of intention and avoidance of attending organized mammography screening in Norway: applying the Extended Parallel Process Model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Ivanova ◽  
Ingela Lundin Kvalem
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Mammography Screening ◽  
Psychological Factors ◽  
Process Model ◽  
Parallel Process ◽  
Extended Parallel Process Model ◽  
Screening Programs ◽  
Response Efficacy

Abstract Background Mammography screening is the main method for early detection of breast cancer in Norway. Few studies have focused on psychological determinants of both attendance and non-attendance of publicly available mammography screening programs. The aim of the current study, guided by the Extended Parallel Process Model, was to examine how psychological factors influence defensive avoidance of breast cancer screening and intention to attend mammography. Methods Cross-sectional survey data from a community sample of women living in Norway aged ≥ 18 (N = 270), and without a history of breast cancer, was collected from September 2018 to June 2019 and used to investigate the relationships between the Extended Parallel Process Model (EPPM) constructs and two outcomes: defensive avoidance of breast cancer screening and intention to attend mammography within the next two years. After adjusting for confounding factors, the hierarchical multiple linear regression analyses was conducted to assess the ability of the independent variables based on the EPPM to predict the two outcome variables. Significance level was chosen at p < 0.05. Results Multivariate analyses showed that defensive avoidance of breast cancer screening was predicted by lower perceived susceptibility to breast cancer (β =  − 0.22, p = 0.001), lower response efficacy of mammography screening (β =  − 0.33, p = 0.001), higher breast cancer fear (β = 0.15, p = 0.014), and checking breasts for lumps (β =  − 0.23, p = 0.001). Intention to attend mammography within the next two years was predicted by higher response efficacy of mammography screening (β = 0.13, p = 0.032), having a lower educational level (β =  − 0.10, p = 0.041), and regular previous mammography attendance compared to never attending (β = 0.49, p = 0.001). Conclusions The study revealed that defensive avoidance of breast cancer screening and intention to attend mammography were not predicted by the same pattern of psychological factors. Our findings suggest future health promotion campaigns need to focus not only on the psychological factors that encourage women’s decision to attend the screening, but also to counter factors that contribute to women’s decision to avoid it.

scholarly journals Can artificial intelligence reduce the interval cancer rate in mammography screening?

2021 ◽  
Author(s):  
Kristina Lång ◽  
Solveig Hofvind ◽  
Alejandro Rodríguez-Ruiz ◽  
Ingvar Andersson
Keyword(s):  
Artificial Intelligence ◽  
Risk Score ◽  
Mammography Screening ◽  
False Negative ◽  
Interval Cancer ◽  
Stage Iv ◽  
True Negative ◽  
Stage Iv Disease ◽  
Interval Cancer Rate ◽  
Screening Mammograms

Abstract Objectives To investigate whether artificial intelligence (AI) can reduce interval cancer in mammography screening. Materials and methods Preceding screening mammograms of 429 consecutive women diagnosed with interval cancer in Southern Sweden between 2013 and 2017 were analysed with a deep learning–based AI system. The system assigns a risk score from 1 to 10. Two experienced breast radiologists reviewed and classified the cases in consensus as true negative, minimal signs or false negative and assessed whether the AI system correctly localised the cancer. The potential reduction of interval cancer was calculated at different risk score thresholds corresponding to approximately 10%, 4% and 1% recall rates. Results A statistically significant correlation between interval cancer classification groups and AI risk score was observed (p < .0001). AI scored one in three (143/429) interval cancer with risk score 10, of which 67% (96/143) were either classified as minimal signs or false negative. Of these, 58% (83/143) were correctly located by AI, and could therefore potentially be detected at screening with the aid of AI, resulting in a 19.3% (95% CI 15.9–23.4) reduction of interval cancer. At 4% and 1% recall thresholds, the reduction of interval cancer was 11.2% (95% CI 8.5–14.5) and 4.7% (95% CI 3.0–7.1). The corresponding reduction of interval cancer with grave outcome (women who died or with stage IV disease) at risk score 10 was 23% (8/35; 95% CI 12–39). Conclusion The use of AI in screen reading has the potential to reduce the rate of interval cancer without supplementary screening modalities. Key Points • Retrospective study showed that AI detected 19% of interval cancer at the preceding screening exam that in addition showed at least minimal signs of malignancy. Importantly, these were correctly localised by AI, thus obviating supplementary screening modalities. • AI could potentially reduce a proportion of particularly aggressive interval cancers. • There was a correlation between AI risk score and interval cancer classified as true negative, minimal signs or false negative.

scholarly journals Comment on: ‘Screening’ for Breast Cancer: Misguided Research Misinforming Public Policies, by O. S. Miettinen

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Karin Huwiler ◽  
Beat Thürlimann ◽  
Thomas Cerny ◽  
Marcel Zwahlen
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Mammography Screening ◽  
Public Policies ◽  
Medical Board

AbstractOur commentary of the article “‘Screening’ for Breast Cancer: Misguided Research Misinforming Public Policies” has two main parts. First we address some of the methodological points raised by Professor Miettinen. Then we review more specific aspects of the Swiss Medical Board statement on mammography screening for early detection of breast cancer.

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