title: Using the European guidelines to evaluate the Norwegian Breast Cancer Screening Program.
abstract: This is an evaluation of selected process indicators achieved during the first 10 years of performance of the Norwegian Breast Cancer Screening Program (NBCSP). The indicators are compared with the recommended levels given in the European Guidelines. The program invites all female residents aged 50-69 years old to two-view mammography biennially. The attendance rate was 76.2%. The recall rates due to positive mammography were 4.6% and 2.6%, and the detection rates were 6.4 and 4.9 per 1,000 screens, in prevalent and subsequent screens, respectively. Mean tumor size was 14.7 mm for screening detected and 21.2 mm for interval cancers. Axillary lymph node metastases were present in 25.4% and 43.8%, respectively. Detection mode (screening detected or interval cancer) was shown to be an independent predictor for axillary lymph node metastases and high-grade (Grade 3) tumors. The NBCSP meets the recommendations given in the European Guidelines for most of the process indicators evaluated in this study. Based on the results, we anticipate a future mortality reduction from breast cancer in women invited to the NBCSP.
authors.affiliation: Department of Screening-based Research, The Cancer Registry of Norway, Montebello, Oslo, 0310, Norway. Solveig.Hofvind@kreftregisteret.no
authors.forename: Solveig
authors.initials: S
authors.lastname: Hofvind
authors.forename: Berta
authors.initials: B
authors.lastname: Geller
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Vacek
authors.forename: Steinar
authors.initials: S
authors.lastname: Thoresen
authors.forename: Per
authors.initials: P
authors.lastname: Skaane
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000453:epidemiology; D042241:Early Diagnosis; D005060:Europe / Q000453:epidemiology; D005260:Female; D006078:Government Programs; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D008327:Mammography / Q000592:standards / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D012042:Registries