[Sensitivity and specificity of the breast screening program in the Isere region based on positive results between 1991 and 1999].
OBJECTIVE
The screening program guidelines specify that the call back rate of women for additional imaging (positive mammogram) should not exceed 7% at initial screening, and 5% at subsequent screening. Materials and methods. Results in the Isere region (12%) have prompted a review of the correlation between the call back rate and indicators of quality (detection rate, sensitivity, specificity, positive predictive value) for the radiologists providing interpretations during that time period.


RESULTS
Three groups of radiologists were identified: the group with call back rate of 10% achieved the best results (sensitivity: 92%, detection rate: 0.53%, specificity: 90%). The group with lowest call back rate (7.7%) showed insufficient sensitivity (58%). The last group with call back rate of 18.3%, showed no improvement in sensitivity (82%) and detection rate (0.53%), but showed reduced specificity (82%).


CONCLUSIONS
The protocol update in 2001 does not resolve this problematic situation and national results continue to demonstrate a high percentage of positive screening mammograms. A significant increase in the number of positive screening examinations compared to recommended guidelines is not advantageous and leads to an overall decrease in the quality of the screening.
Garnier
A
A
Office De Lutte contre le Cancer, 7, av du Granier, 38240 Meylan. anne.garnier@odlc.org
Poncet
F
F
Billette De Villemeur
A
A
Exbrayat
C
C
Bon
M F
MF
Chevalier
A
A
Salicru
B
B
Tournegros
J M
JM
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005189:False Positive Reactions; D005260:Female; D005602:France; D006801:Humans; D008327:Mammography / Q000592:standards / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000592:standards; D012015:Reference Standards; D012680:Sensitivity and Specificity