[The effectiveness of population-based breast cancer screening programme].
Well-organised mammography screening programme can significantly reduce the breast cancer mortality However, changes in mortality rates take a long time thus some early indicators are usually used to monitor the effectiveness of the programme. If these operational objectives are accomplished then the programme can replicate the mortality reduction achieved in randomised trials.


OBJECTIVE
To evaluate the quality of breast cancer screening programme in the region of Lower Silesia during the first year of its operating.


METHODS
Centrally organised breast cancer screening has been introduced since the beginning of the year 2007. This population-based programme is designed for women aged 50-69. Females undergoing treatment or being followed-up due to breast cancer are not invited. Screen-film two-view mammography without clinical examination is used as a screening test which is to be performed every two years. The second level diagnostic tools are breast clinical examination and additional imaging (mammography and ultrasound). Following further assessment women are referred to the examination at the routine round length of the programme, at the less interval (short-term recall) or biopsy procedures. Quality assessment was done via early indicators according to the European guidelines.


RESULTS
The attendance rate was 41% (79,143 women screened within 192,613 eligible population for one year). Technical repeat rate, further assessment rate, and short-term recall rate were: 0.26%, 6.85%, and 0.91%, respectively. Pathologically confirmed breast cancer was revealed in 364 women giving the detection rate 4.59 for 1000. Cancer detection rate to expected incidence ratio was 3.35.


CONCLUSIONS
Mammography service performed during the first year of breast cancer screening programme in the region of Lower Silesia conforms to quality assessment parameters recommended by the European guidelines at the acceptable level. The main problem at the start of this programme is too low coverage. Invitation process must be strongly intensified to improve long-term effectiveness and to significantly reduce breast cancer mortality.
Szynglarewicz
Bartłomiej
B
'Lower Silesian Oncology Centre in Wroclaw, 2nd Department of Surgical Oncology, Poland. szynglarewicz.b@dco.com.pl
Matkowski
Rafał
R
Kasprzak
Piotr
P
Kotowska
Jolanta
J
Forgacz
Józef
J
Pudełko
Marek
M
Kornafel
Jan
J
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D055088:Early Detection of Cancer; D005260:Female; 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; D009313:National Health Programs; D011044:Poland; D015397:Program Evaluation