Sonia Maria da Silva , João Emilio Peixoto , Flávia Engel Aduan , Linei Augusta Urban , Leonardo Vieira Travassos , Ellyete Oliveira Canella , Salete Fonseca Rego , Alex Camara Campos , Anna Maria Araújo , Marcela Brisighelli Schaefer , Ana Lucia Kefalas , José Luis Francisco , Norma Medicis Maranhão , Radiá Pereira dos Santos , Selma di Pace Bauab , José Michel Kalaf , Luciano Fernades Chala , Henrique Lima Couto , Rosangela Requi Jakubiak , Gabriel Wingler Tinoco
{"title":"巴西的两个国家乳房X光检查质量认证项目：2017年至2021年的框架和主要成果","authors":"Sonia Maria da Silva , João Emilio Peixoto , Flávia Engel Aduan , Linei Augusta Urban , Leonardo Vieira Travassos , Ellyete Oliveira Canella , Salete Fonseca Rego , Alex Camara Campos , Anna Maria Araújo , Marcela Brisighelli Schaefer , Ana Lucia Kefalas , José Luis Francisco , Norma Medicis Maranhão , Radiá Pereira dos Santos , Selma di Pace Bauab , José Michel Kalaf , Luciano Fernades Chala , Henrique Lima Couto , Rosangela Requi Jakubiak , Gabriel Wingler Tinoco","doi":"10.1016/j.jcpo.2023.100437","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>This study aims to provide an academic medical overview of the framework and key outcomes of two mammography quality certification programs in Brazil.</p></div><div><h3>Methods</h3><p>These programs assess radiation dose and phantom image quality in mammography units through a postal system. Each unit that passes this initial assessment is required to submit a sample of copies of five complete examinations. The quality of the patient images and reports is then reviewed by radiologists and medical physicist experts. Additionally, the number of mammography units and mammography coverage in the target population, were assessed.</p></div><div><h3>Results</h3><p>During the study period, 1007 units applied to the certification programs, and 934 (92.8%) successfully passed the assessment of radiation dose and phantom image quality. Out of these, 556 (59.5%) also passed the review of clinical image quality and reports, earning certification. The main issues related to mammogram and report quality were associated with the performance of radiographers (in terms of positioning) and radiologists (in terms of interpretation). On average, there are more than two mammography units/10,000 women in the target group. The screening mammography coverage in this group is 26.3% for women relying exclusively on the public healthcare and 58.1% for women with private healthcare plans.</p></div><div><h3>Conclusion</h3><p>This study demonstrates the suitability of the framework adopted by national mammography quality certification programs in a middle-income country. These programs are carried out by relatively small workforce and at reasonable costs, utilizing postal resources to cover the large number of existing mammographic units and the vast distances within the country.</p></div><div><h3>P<strong>olicy statement</strong></h3><p>All mammography services in Brazil must adhere to the quality requirements for examinations and reference values for radiation dose to women established by the Ministry of Health. This ensures standardized conditions for early detection of breast cancer and minimizes the risk associated with x-rays.</p></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":"38 ","pages":"Article 100437"},"PeriodicalIF":2.0000,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Two national mammography quality certification programs in Brazil: Framework and main outcomes between 2017 and 2021\",\"authors\":\"Sonia Maria da Silva , João Emilio Peixoto , Flávia Engel Aduan , Linei Augusta Urban , Leonardo Vieira Travassos , Ellyete Oliveira Canella , Salete Fonseca Rego , Alex Camara Campos , Anna Maria Araújo , Marcela Brisighelli Schaefer , Ana Lucia Kefalas , José Luis Francisco , Norma Medicis Maranhão , Radiá Pereira dos Santos , Selma di Pace Bauab , José Michel Kalaf , Luciano Fernades Chala , Henrique Lima Couto , Rosangela Requi Jakubiak , Gabriel Wingler Tinoco\",\"doi\":\"10.1016/j.jcpo.2023.100437\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>This study aims to provide an academic medical overview of the framework and key outcomes of two mammography quality certification programs in Brazil.</p></div><div><h3>Methods</h3><p>These programs assess radiation dose and phantom image quality in mammography units through a postal system. Each unit that passes this initial assessment is required to submit a sample of copies of five complete examinations. The quality of the patient images and reports is then reviewed by radiologists and medical physicist experts. Additionally, the number of mammography units and mammography coverage in the target population, were assessed.</p></div><div><h3>Results</h3><p>During the study period, 1007 units applied to the certification programs, and 934 (92.8%) successfully passed the assessment of radiation dose and phantom image quality. Out of these, 556 (59.5%) also passed the review of clinical image quality and reports, earning certification. The main issues related to mammogram and report quality were associated with the performance of radiographers (in terms of positioning) and radiologists (in terms of interpretation). On average, there are more than two mammography units/10,000 women in the target group. The screening mammography coverage in this group is 26.3% for women relying exclusively on the public healthcare and 58.1% for women with private healthcare plans.</p></div><div><h3>Conclusion</h3><p>This study demonstrates the suitability of the framework adopted by national mammography quality certification programs in a middle-income country. These programs are carried out by relatively small workforce and at reasonable costs, utilizing postal resources to cover the large number of existing mammographic units and the vast distances within the country.</p></div><div><h3>P<strong>olicy statement</strong></h3><p>All mammography services in Brazil must adhere to the quality requirements for examinations and reference values for radiation dose to women established by the Ministry of Health. 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Two national mammography quality certification programs in Brazil: Framework and main outcomes between 2017 and 2021
Background
This study aims to provide an academic medical overview of the framework and key outcomes of two mammography quality certification programs in Brazil.
Methods
These programs assess radiation dose and phantom image quality in mammography units through a postal system. Each unit that passes this initial assessment is required to submit a sample of copies of five complete examinations. The quality of the patient images and reports is then reviewed by radiologists and medical physicist experts. Additionally, the number of mammography units and mammography coverage in the target population, were assessed.
Results
During the study period, 1007 units applied to the certification programs, and 934 (92.8%) successfully passed the assessment of radiation dose and phantom image quality. Out of these, 556 (59.5%) also passed the review of clinical image quality and reports, earning certification. The main issues related to mammogram and report quality were associated with the performance of radiographers (in terms of positioning) and radiologists (in terms of interpretation). On average, there are more than two mammography units/10,000 women in the target group. The screening mammography coverage in this group is 26.3% for women relying exclusively on the public healthcare and 58.1% for women with private healthcare plans.
Conclusion
This study demonstrates the suitability of the framework adopted by national mammography quality certification programs in a middle-income country. These programs are carried out by relatively small workforce and at reasonable costs, utilizing postal resources to cover the large number of existing mammographic units and the vast distances within the country.
Policy statement
All mammography services in Brazil must adhere to the quality requirements for examinations and reference values for radiation dose to women established by the Ministry of Health. This ensures standardized conditions for early detection of breast cancer and minimizes the risk associated with x-rays.
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