Journal of Medical Screening最新文献

{"title":"Barriers and facilitators of abdominal aortic aneurysm screening in London: A cross-sectional survey.","authors":"Ellie McKay, Joy Wong, Stella Ward, Josephine Ruwende, Robert Kerrison","doi":"10.1177/09691413241276187","DOIUrl":"https://doi.org/10.1177/09691413241276187","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this research was to identify patient barriers and facilitators of abdominal aortic aneurysm (AAA) screening in London.</p><p><strong>Methods: </strong>A survey was distributed to 4211 adults, who had been invited for AAA screening in 2023. Barriers and facilitators were identified by comparing responses between attenders and non-attenders, using univariate logistic regression.</p><p><strong>Results: </strong>271 surveys were returned. Attendance was higher among respondents with a body mass index (BMI) > 25 (odds ratio [OR]: 2.72, 95% CIs [1.15, 6.46]; <i>p</i> < 0.05) and those with one or more comorbidities (OR: 3.82, 95% CIs [1.63, 8.98]; <i>p</i> < 0.01), but lower among those who had not visited a healthcare appointment within the past 6 months (OR: 0.41, 95% CIs [0.18, 0.94]). Attendance was also lower among those who believe screening is only useful for people with symptoms (OR: 0.37; 95% CIs [0.16, 0.89]; <i>p</i> < 0.05), find it difficult to make time for medical appointments (OR: 0.25, 95% CIs [0.10, 0.60]; <i>p</i> < 0.01), find it difficult to get to medical appointments (OR: 0.40, 95% CIs [0.17, 0.91]; <i>p</i> < 0.05), have more important medical problems to worry about (OR: 0.28, 95% CIs [0.12, 0.64]; <i>p</i> < 0.01), cannot afford to travel to medical appointments (OR: 0.16, 95% CIs [0.07, 0.38]; <i>p</i> < 0.001), need help getting to appointments (OR: 0.33, 95% CIs [0.13, 0.86]; <i>p</i> < 0.05), have caring responsibilities (OR: 0.15, 95% CIs [0.06, 0.34]; <i>p</i> < 0.001), and forget about appointments (OR: 0.21, 95% CIs [0.09, 0.49]; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>This study provides suggestive data on characteristics that might be associated with not attending AAA screening in London. The study design limitations mean that further work is required to evaluate these characteristics more reliably.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413241276187"},"PeriodicalIF":2.6,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulated arbitration of discordance between radiologists and artificial intelligence interpretation of breast cancer screening mammograms.","authors":"M Luke Marinovich, William Lotter, Andrew Waddell, Nehmat Houssami","doi":"10.1177/09691413241262960","DOIUrl":"https://doi.org/10.1177/09691413241262960","url":null,"abstract":"<p><p>Artificial intelligence (AI) algorithms have been retrospectively evaluated as replacement for one radiologist in screening mammography double-reading; however, methods for resolving discordance between radiologists and AI in the absence of 'real-world' arbitration may underestimate cancer detection rate (CDR) and recall. In 108,970 consecutive screens from a population screening program (BreastScreen WA, Western Australia), 20,120 were radiologist/AI discordant without real-world arbitration. Recall probabilities were randomly assigned for these screens in 1000 simulations. Recall thresholds for screen-detected and interval cancers (sensitivity) and no cancer (false-positive proportion, FPP) were varied to calculate mean CDR and recall rate for the entire cohort. Assuming 100% sensitivity, the maximum CDR was 7.30 per 1000 screens. To achieve >95% probability that the mean CDR exceeded the screening program CDR (6.97 per 1000), interval cancer sensitivities ≥63% (at 100% screen-detected sensitivity) and ≥91% (at 80% screen-detected sensitivity) were required. Mean recall rate was relatively constant across sensitivity assumptions, but varied by FPP. FPP > 6.5% resulted in recall rates that exceeded the program estimate (3.38%). CDR improvements depend on a majority of interval cancers being detected in radiologist/AI discordant screens. Such improvements are likely to increase recall, requiring careful monitoring where AI is deployed for screen-reading.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413241262960"},"PeriodicalIF":2.6,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining breast cancer screening recommendations in Canada: The projected resource impact of screening among women aged 40-49.","authors":"Robert B Basmadjian, Yibing Ruan, John M Hutchinson, Matthew T Warkentin, Oguzhan Alagoz, Andrew Coldman, Darren R Brenner","doi":"10.1177/09691413241267845","DOIUrl":"https://doi.org/10.1177/09691413241267845","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the resource use of revising breast cancer screening guidelines to include average-risk women aged 40-49 years across Canada from 2024 to 2043 using a validated microsimulation model.</p><p><strong>Setting: </strong>OncoSim-Breast microsimulation platform was used to simulate the entire Canadian population in 2015-2051.</p><p><strong>Methods: </strong>We compared resource use between current screening guidelines (biennial screening ages 50-74) and alternate screening scenarios, which included annual and biennial screening for ages 40-49 and ages 45-49, followed by biennial screening ages 50-74. We estimated absolute and relative differences in number of screens, abnormal screening recalls without cancer, total and negative biopsies, screen-detected cancers, stage of diagnosis, and breast cancer deaths averted.</p><p><strong>Results: </strong>Compared with current guidelines in Canada, the most intensive screening scenario (annual screening ages 40-49) would result in 13.3% increases in the number of screens and abnormal screening recalls without cancer whereas the least intensive scenario (biennial screening ages 45-49) would result in a 3.4% increase in number of screens and 3.8% increase in number of abnormal screening recalls without cancer. More intensive screening would be associated with fewer stage II, III, and IV diagnoses, and more breast cancer deaths averted.</p><p><strong>Conclusions: </strong>Revising breast cancer screening in Canada to include average-risk women aged 40-49 would detect cancers earlier leading to fewer breast cancer deaths. To realize this potential clinical benefit, a considerable increase in screening resources would be required in terms of number of screens and screen follow-ups. Further economic analyses are required to fully understand cost and budget implications.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413241267845"},"PeriodicalIF":2.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HPV self-sampling in organized cervical cancer screening program: A randomized pilot study in Estonia in 2021.","authors":"Reeli Hallik, Kaire Innos, Jaak Jänes, Kai Jõers, Kaspar Ratnik, Piret Veerus","doi":"10.1177/09691413241268819","DOIUrl":"https://doi.org/10.1177/09691413241268819","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer incidence in Estonia ranks among the highest in Europe, but screening attendance has remained low. This randomized study aimed to evaluate the impact of opt-in and opt-out human papillomavirus (HPV) self-sampling options on participation in organized screening.</p><p><strong>Methods: </strong>A random sample of 25,591 women were drawn from the cervical cancer screening target population who were due to receive a reminder in autumn 2021 and thereafter randomly allocated to two equally sized intervention arms (opt-out and opt-in) receiving a choice between HPV self-sampling or clinician sampling. In the opt-out arm, a self-sampler was sent to home address by regular mail; the opt-in arm received an e-mail containing a link to order a self-sampler online. The remaining 30,102 women in the control group received a standard reminder for conventional screening. Participation by intervention arm, age and region of residence was calculated; a questionnaire was used to assess self-sampling user experience.</p><p><strong>Results: </strong>A significant difference in participation was seen between opt-out (41.7%) (19.8% chose self-sampling and 21.9% clinician sampling), opt-in (34.1%) (7.9% self-sampling, 26.2% clinician sampling) and control group (29.0%, clinician sampling only). All age groups and regions in the intervention arms showed higher participation compared to the control group, but the size of the effect varied. Among self-sampling users, 99% agreed that the device was easy to use and only 3.5% preferred future testing at the clinic.</p><p><strong>Conclusion: </strong>Providing women with a choice between self-sampling and clinician sampling significantly increased participation in cervical cancer screening. Opt-in and opt-out options had a different effect across age groups, suggesting the need to adapt strategies.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413241268819"},"PeriodicalIF":2.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction of one-view tomosynthesis in population-based mammography screening: Impact on detection rate, interval cancer rate and false-positive rate.","authors":"Bolette Mikela Vilmun, George Napolitano, Martin Lillholm, Rikke Rass Winkel, Elsebeth Lynge, Mads Nielsen, Michael Bachmann Nielsen, Jonathan Frederik Carlsen, My von Euler-Chelpin, Ilse Vejborg","doi":"10.1177/09691413241262259","DOIUrl":"https://doi.org/10.1177/09691413241262259","url":null,"abstract":"<p><strong>Objective: </strong>To assess performance endpoints of a combination of digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) compared with FFDM only in breast cancer screening.</p><p><strong>Materials and methods: </strong>This was a prospective population-based screening study, including eligible (50-69 years) women attending the Capital Region Mammography Screening Program in Denmark. All attending women were offered FFDM. A subgroup was consecutively allocated to a screening room with DBT. All FFDM and DBT underwent independent double reading, and all women were followed up for 2 years after screening date or until next screening date, whichever came first.</p><p><strong>Results: </strong>6353 DBT + FFDM and 395 835 FFDM were included in the analysis and were undertaken in 196 267 women in the period from 1 November 2012 to 12 December 2018. Addition of DBT increased sensitivity: 89.9% (95% confidence interval (CI): 81.0-95.5) for DBT + FFDM and 70.1% (95% CI: 68.6-71.6) for FFDM only, <i>p </i>< 0.001. Specificity remained similar: 98.2% (95% CI: 97.9-98.5) for DBT + FFDM and 98.3% (95% CI: 98.2-98.3) for FFDM only, <i>p </i>= 0.9. Screen-detected cancer rate increased statistically significantly: 11.18/1000 for DBT + FFDM and 6.49/1000 for FFDM only, <i>p </i>< 0.001. False-positive rate was unchanged: 1.75% for DBT + FFDM and 1.73% for FFDM only, <i>p </i>= 0.9. Positive predictive value for recall was 39.0% (95% CI: 31.9-46.5) for DBT + FFDM and 27.3% (95% CI: 26.4-28.2), for FFDM only, <i>p </i>< 0.0005. The interval cancer rate decreased: 1.26/1000 for DBT + FFDM and 2.76/1000 for FFDM only, <i>p </i>= 0.02.</p><p><strong>Conclusion: </strong>DBT + FFDM yielded a statistically significant increase in cancer detection and program sensitivity.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"9691413241262259"},"PeriodicalIF":2.6,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the healthcare failure mode and effects analysis approach to improve the quality of an organised colorectal cancer screening programme.","authors":"Angela Chiereghin, Lorena Squillace, Lorenzo Pizzi, Carmen Bazzani, Lorenzo Roti, Francesca Mezzetti","doi":"10.1177/09691413231197300","DOIUrl":"10.1177/09691413231197300","url":null,"abstract":"<p><strong>Objective: </strong>The first level of a colorectal cancer (CRC) screening process was systematically analysed using the Healthcare Failure Mode and Effects Analysis (HFMEA) approach by a multidisciplinary team aiming to improve the programme quality.</p><p><strong>Setting: </strong>The study was conducted at the Local Health Authority of Bologna, Northern Italy.</p><p><strong>Methods: </strong>Seven brainstorming sessions were conducted and all the activities performed were recorded on a FMEA worksheet consisting of individual records reporting the specific phases of the analysed process along with associated activities, possible failure modes, their causes and effects, the obtained risk priority numbers (RPNs) and the control measures to plan.</p><p><strong>Results: </strong>Twenty-three failure modes, 14 effects and 12 possible causes were identified. Nine failure modes were prioritised according to the RPN obtained; most resulted in possible false-negative faecal immunochemical test (FIT) results (66.7%), followed by sample loss (22.2%) and not reaching the entire target population (11.1%). This leads to 66.7% of corrective/preventive actions being applied to the phase of returning the stool sample by the citizen. For this phase reorganisation, the local pharmacies were involved not only as FIT kit delivery points but also as specimen collection and sending points to the laboratory. These organisational changes allowed the introduction of complete traceability of kits and specimens flow, as well as temperature control. A re-evaluation of the prioritised failure modes 6 months after launching the implemented screening process showed that HFMEA application decreased the risk of potential errors by 75.9%.</p><p><strong>Conclusion: </strong>HFMEA application in CRC screening programme is a useful tool to reduce potential errors.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"70-77"},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10169912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing screening based on the NHS Health Check and Polypill Prevention Programmes in the primary prevention of heart attacks and strokes.","authors":"Nicholas J Wald, Aroon D Hingorani, Stephen H Vale, Jonathan P Bestwick, Joan Morris","doi":"10.1177/09691413241235488","DOIUrl":"10.1177/09691413241235488","url":null,"abstract":"<p><strong>Objective: </strong>To compare the NHS Health Check Programme with the Polypill Prevention Programme in the primary prevention of heart attacks and strokes.</p><p><strong>Design: </strong>Use of published data and methodology to produce flow charts of the two programmes to determine screening performance and heart attacks and strokes prevented.</p><p><strong>Setting: </strong>The UK population.</p><p><strong>Intervention: </strong>The NHS Health Check Programme using a QRISK score on people aged 40-74 to select those eligible for a statin is compared with the Polypill Prevention Programme in people aged 50 or more to select people for a combination of a statin and three low-dose blood pressure lowering agents. In both programmes, people had no history of heart attack or stroke.</p><p><strong>Main outcome measures: </strong>In 1000 people, the number of heart attacks and strokes prevented in the two programmes.</p><p><strong>Results: </strong>In the hypothetical perfect situation with 100% uptake and adherence to the screening protocol, in every 1000 persons, the NHS Health Check would prevent 287 cases of a heart attack or stroke in individuals who would gain on average about 4 years of life without a heart attack or stroke amounting to 1148 years in total, the precise gain depending on the extent of treatment for those with raised blood pressure, and 136 would be prescribed statins with no benefit. The corresponding figures for the Polypill Prevention Programme are 316 individuals who would, on average, gain 8 years of life without a heart attack or stroke, amounting to 2528 years in total, and 260 prescribed the polypill with no benefit. Based on published estimates of uptake and adherence in the NHS Health Check Programme, in practice only 24 cases per 1000 are currently benefitting instead of 287, amounting to 96 years gained without a heart attack or stroke.</p><p><strong>Conclusions: </strong>The Polypill Prevention Programme is by design simpler with the potential of preventing many more heart attacks and strokes than the NHS Health Check Programme.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"59-65"},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11083722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and knowledge about HPV and primary HPV screening among women in Great Britain: An online population-based survey.","authors":"Jo Waller, Frances Waite, Laura Marlow","doi":"10.1177/09691413231205965","DOIUrl":"10.1177/09691413231205965","url":null,"abstract":"<p><strong>Objectives: </strong>Human papillomavirus (HPV) primary testing for cervical screening is being implemented around the world. We explored HPV awareness, and knowledge about primary screening in Great Britain (England, Scotland and Wales), where it has been in place for several years, ahead of extended screening intervals being implemented in England.</p><p><strong>Setting/methods: </strong>Women aged 18-70 (<i>n</i> = 1995) were recruited by YouGov from their online panel in August 2022. The weighted sample (<i>n</i> = 1930) was population-representative by age, region, education and social grade. We measured HPV awareness, knowledge (excluding those unaware of HPV) using eight true/false items, and understanding of the role of HPV testing in cervical screening.</p><p><strong>Results: </strong>Overall, 77.6% (1499/1930) of women were aware of HPV. When asked to identify the statement describing how cervical screening works, only 12.2% (236/1930) correctly selected the statement reflecting HPV primary screening (13.5% (194/1436) in screening-eligible women). Excluding those unaware of HPV, most participants had heard about the virus in the context of cervical screening (981/1596; 61.5%) or HPV vaccination (1079/1596; 67.6%). Mean knowledge score was 3.7 out of 8 (SD = 2.2) in this group. Most knew that an HPV-positive result does not mean a woman will definitely develop cervical cancer (1091/1499; 72.8%) but far fewer were aware of the long timeline for HPV to develop into cervical cancer (280/1499; 18.7%).</p><p><strong>Conclusions: </strong>Only three-quarters of women in Britain are aware of HPV, and knowledge of primary screening is very low, even among screening-age women. This points to continued need for awareness-raising campaigns to ensure informed choice about screening and mitigate public concern when screening intervals are extended.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"91-98"},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11083738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact on clinical outcomes and healthcare resources from discontinuing colonoscopy surveillance subsequent to low-risk adenoma removal: A simulation study using the OncoSim-Colorectal model.","authors":"Kieran Jd Steer, Zhuolu Sun, Daniel C Sadowski, Jean H E Yong, Andrew Coldman, Nicole Nemecek, Huiming Yang","doi":"10.1177/09691413231202877","DOIUrl":"10.1177/09691413231202877","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the impact on clinical outcomes and healthcare resource use from recommending that patients with 1-2 low-risk adenomas (LRAs) return to routine fecal immunochemical test (FIT) screening instead of surveillance colonoscopy, from a Canadian provincial healthcare system perspective.</p><p><strong>Methods: </strong>The OncoSim-Colorectal microsimulation model simulated average-risk individuals eligible for FIT-based colorectal cancer (CRC) screening in Alberta, Canada. We simulated two surveillance strategies that applied to individuals with 1-2 LRAs (<10 mm) removed as part of the average risk CRC screening program: (a) Surveillance colonoscopy (status quo) and (b) return to FIT screening (new strategy); both at 5 years after polypectomy. A 75 ng/mL FIT positivity threshold was used in the base case. The simulations projected average annual CRC outcomes and healthcare resource use from 2023 to 2042. We conducted alternative scenarios and sensitivity analyses on key variables.</p><p><strong>Results: </strong>Returning to FIT screening (versus surveillance colonoscopy) after polypectomy was projected to have minimal impact on long-term CRC incidence and deaths (not statistically significant). There was a projected decrease of one (4%) major bleeding event and seven (5%) perforation events per year. There was a projected increase of 4800 (1.5%) FIT screens, decrease of 3900 (5.1%) colonoscopies, and a decrease of $3.4 million (1.2%) in total healthcare costs per year, on average. The annual colonoscopies averted and healthcare cost savings increased over time. Results were similar in the alternative scenarios and sensitivity analyses.</p><p><strong>Conclusions: </strong>Returning to FIT screening would have similar clinical outcomes as surveillance colonoscopy but could reduce colonoscopy demand and healthcare costs.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"78-84"},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11083724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early performance measures following regular versus irregular screening attendance in the population-based screening program for breast cancer in Norway.","authors":"Jonas E Thy, Marthe Larsen, Einar Vigeland, Henrik Koch, Tone Hovda, Solveig Hofvind","doi":"10.1177/09691413231199583","DOIUrl":"10.1177/09691413231199583","url":null,"abstract":"<p><strong>Objective: </strong>Irregular attendance in breast cancer screening has been associated with higher breast cancer mortality compared to regular attendance. Early performance measures of a screening program following regular versus irregular screening attendance have been less studied. We aimed to investigate early performance measures following regular versus irregular screening attendance.</p><p><strong>Methods: </strong>We used information from 3,302,396 screening examinations from the Cancer Registry of Norway. Examinations were classified as regular or irregular. Regular was defined as an examination 2 years ± 6 months after the prior examination, and irregular examination >2 years and 6 months after prior examination. Performance measures included recall, biopsy, screen-detected and interval cancer, positive predictive values, and histopathological tumor characteristics.</p><p><strong>Results: </strong>Recall rate was 2.4% (72,429/3,070,068) for regular and 3.5% (8217/232,328) for irregular examinations. The biopsy rate was 1.0% (29,197/3,070,068) for regular and 1.7% (3825/232,328) for irregular examinations, while the rate of screen-detected cancers 0.51% (15,664/3,070,068) versus 0.86% (2003/232,328), respectively. The adjusted odds ratio was 1.53 (95% CI: 1.49-1.56) for recall, 1.73 (95% CI: 1.68-1.80) for biopsy, and 1.68 (95% CI: 1.60-1.76) for screen-detected cancer after irregular examinations compared to regular examinations. The proportion of lymph node-positive tumors was 20.1% (2553/12,719) for regular and 25.6% (426/1662) for irregular examinations.</p><p><strong>Conclusion: </strong>Irregular attendance was linked to higher rates of recall, needle biopsies, and cancer detection. Cancers detected after irregular examinations had less favorable histopathological tumor characteristics compared to cancers detected after regular examinations. Women should be encouraged to attend screening when invited to avoid delays in diagnosis.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":" ","pages":"107-114"},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10570416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}