[Initial results with breast screening in the Enschede area. II. Efficiency].
The efficiency of breast cancer screening in the Enschede region was evaluated after 18 months on the basis of unfavourable side effects and possible difficulties. These side effects were: 1. for women: psychological burden, period of uncertainty and increasing waiting times; 2. for general practitioners: limited referral; 3. for specialists: increased diagnostics and consultation. The results were compared with the figures derived from the national cost-effectiveness analysis. The psychological burden on women with a positive screening result appeared to be considerable, in conjunction with the length of the period of uncertainty. The final result was only known after approximately five weeks when a biopsy was required. In 83 women (41% of all referred women) the overall result of the procedure was false-positive. Occasionally the woman was not referred to a known specialist centre, in contradiction to the guidelines. The increase in the number of diagnostic and therapeutic operations was larger than expected, and is largely accounted for by the radical increase of clinically non-palpable tumours (factor 17). On average, the waiting time for the (first) biopsy was three weeks. A great deal of multi-disciplinary consultation was necessary because of the large increase of non-palpable tumours and in-situ ductal carcinomas.(ABSTRACT TRUNCATED AT 250 WORDS)
Boekema
A G
AG
Integraal Kankercentrum Stedendriehoek Twente, Enschede.
Dornseiffen
G
G
Mulder
H J
HJ
de Vos
R A
RA
Kluft-de Haas
B A
BA
D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015397:Program Evaluation; D012017:Referral and Consultation; D013315:Stress, Psychological; D013997:Time Factors
De eerste ervaring met mammascreening in de regio Enschede. II. Doelmatigheid.