Dutch digital breast cancer screening: implications for breast cancer care
| Autor: | Eddy M. M. Adang, André L. M. Verbeek, J. M. H. Timmers, Gerard J. den Heeten, J.D.M. Otten, Mireille J. M. Broeders |
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| Přispěvatelé: | CCA -Cancer Center Amsterdam, APH - Amsterdam Public Health, Biomedical Engineering and Physics, Radiology and Nuclear Medicine |
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Digital mammography Referral Biopsy Cost-Benefit Analysis Quality of nursing and allied health care [NCEBP 6] Breast Neoplasms Breast cancer screening Breast cancer Evaluation of complex medical interventions Aetiology screening and detection [NCEBP 2] Predictive Value of Tests Evaluation of complex medical interventionsQuality of Care [NCEBP 2] Chart review Outcome Assessment Health Care medicine Mammography Humans Mass Screening Referral and Consultation Early Detection of Cancer Molecular epidemiology Aetiology screening and detection [NCEBP 1] Aged Netherlands Gynecology medicine.diagnostic_test Obstetrics business.industry Public Health Environmental and Occupational Health Effective primary care and public health [NCEBP 7] European population Middle Aged medicine.disease Predictive value Survival Rate Female business Delivery of Health Care Program Evaluation |
| Zdroj: | European Journal of Public Health, 22, 925-9 European journal of public health, 22(6), 925-929. Oxford University Press European Journal of Public Health, 22, 6, pp. 925-9 |
| ISSN: | 1101-1262 |
| Popis: | Item does not contain fulltext BACKGROUND: In comparison to other European population-based breast cancer screening programmes, the Dutch programme has a low referral rate, similar breast cancer detection and a high breast cancer mortality reduction. The referral rate in the Netherlands has increased over time and is expected to rise further, mainly following nationwide introduction of digital mammography, completed in 2010. This study explores the consequences of the introduction of digital mammography on the balance between referral rate, detection of breast cancer, diagnostic work-up and associated costs. METHODS: Detailed information on diagnostic work-up (chart review) was obtained from referred women (n = 988) in 2000-06 (100% analogue mammography) and 2007 (75% digital mammography) in Nijmegen, the Netherlands. RESULTS: The average referral rate increased from 15 (2000-06) to 34 (2007) per 1000 women screened. The number of breast cancers detected increased from 5.5 to 7.8 per 1000 screens, whereas the positive predictive value fell from 37% to 23%. A sharp rise in diagnostic work-up procedures and total diagnostic costs was seen. On the other hand, costs of a single work-up slightly decreased, as less surgical biopsies were performed. CONCLUSION: Our study shows that a low referral rate in combination with the introduction of digital mammography affects the balance between referral rate and detection rate and can substantially influence breast cancer care and associated costs. Referral rates in the Netherlands are now more comparable to other countries. This effect is therefore of value in countries where implementation of digital breast cancer screening has just started or is still under discussion. |
| Databáze: | OpenAIRE |
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