Breast cancer screening in Navarra : Interpretation of a high detection rate at the first screening round and a low rate at the second round.
Our objective was to evaluate the on-going European pilot project for breast cancer screening in Navarra, Spain, and to predict the effects and costs of the programme in the long run.
Observed results in Navarra, consisting of more than 100,000 screens, were compared with expected results.
A microsimulation screening analysis model was used that included demographical, epidemiological and screening characteristics of Navarra.
Alternative assumptions on epidemiological and screening characteristics were also addressed.
The observed detection rate (5.9 per 1,000 screened women) in the first round was 18% higher than expected ; the observed rate in the subsequent round (2.9) was 17% lower than expected.
Longer pre-clinical durations, lower sensitivity or the existence of a high-risk group in Navarra could not satisfactorily explain the first and second round results together.
Nevertheless, the programme will have an important health benefit for the women involved, due to an important trend in incidence in recent years and the relatively unfavourable clinical stage distribution in Navarra.
The proportion T2+cancers that will be prevented after 10 years of screening amounts to 36%. The annual mortality reduction in steady state is expected to range between 17% (if the observed rates in the second round indicate real screening performance) to 23% (if the first round indicates real performance). (...)
Mots-clés Pascal : Tumeur maligne, Glande mammaire, Dépistage, Espagne, Europe, Programme sanitaire, Homme, Glande mammaire pathologie
Mots-clés Pascal anglais : Malignant tumor, Mammary gland, Medical screening, Spain, Europe, Sanitary program, Human, Mammary gland diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0038687
Code Inist : 002B20E02. Création : 17/04/1998.