title: [Initial results with breast screening in the Enschede area. I. Effectiveness].
abstract: After one year, the effects of breast cancer screening in the region of Enschede were evaluated by means of seven parameters indicating the long-term health benefits. These parameters were: attendance rate, predictive value of a positive screening test, detection rate, incidence rate, tumour stage, surgical possibilities and type of surgical operations. The results were compared with figures from the national cost-effectiveness analysis. The attendance rate (79%), the predictive value (57%) and the detection rate (0.74%) were well over the national figures of 70%, 41% and 0.64%, respectively. The incidence of breast cancer in the age group 50-69 was 2.5 times higher, as expected. The tumour stage differed significantly (p less than 0.001) from the stages of regularly detected tumours; there was a shift to the lower stages (average tumour size was halved). The surgical possibilities increased significantly (p less than 0.01) and surgical operations performed were mostly less mutilating (not significant). We conclude that the screening for breast cancer in the Enschede region fulfills the criteria of efficacy. It is particularly the combination of a high predictive value and a relatively high detection rate compared with the clinical incidence in the previous years that is indicative of the efficacy. This does not mean that the results prove the long term health benefits of screening for breast cancer. They only give an indication of the future efficacy of screening. The impact on the quality of life is still an open question.
authors.affiliation: Integraal Kankercentrum Stedendriehoek Twente, Enschede.
authors.forename: A G
authors.initials: AG
authors.lastname: Boekema
authors.forename: G
authors.initials: G
authors.lastname: Dornseiffen
authors.forename: H J
authors.initials: HJ
authors.lastname: Mulder
authors.forename: R A
authors.initials: RA
authors.lastname: de Vos
authors.forename: B A
authors.initials: BA
authors.lastname: Kluft-de Haas
mesh_terms: D000368:Aged; D000465:Algorithms; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests
vernacular_title: De eerste ervaring met mammascreening in de regio Enschede. I. Effectiviteit.