title: Mammography-based screening program: preliminary results from a first 2-year round in a Brazilian region using mobile and fixed units.
abstract: BACKGROUND
  Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer deaths among women worldwide. The use of mobile mammography units to offer screening to women living in remote areas is a rational strategy to increase the number of women examined. This study aimed to evaluate results from the first 2 years of a government-organized mammography screening program implemented with a mobile unit (MU) and a fixed unit (FU) in a rural county in Brazil. The program offered breast cancer screening to women living in Barretos and the surrounding area.
  
  
  METHODS
  Based on epidemiologic data, 54 238 women, aged 40 to 69 years, were eligible for breast cancer screening. The study included women examined from April 1, 2003 to March 31, 2005. The chi-square test and Bonferroni correction analyses were used to evaluate the frequencies of tumors and the importance of clinical parameters and tumor characteristics. Significance was set at p < 0.05.
  
  
  RESULTS
  Overall, 17 964 women underwent mammography. This represented 33.1% of eligible women in the area. A mean of 18.6 and 26.3 women per day were examined in the FU and MU, respectively. Seventy six patients were diagnosed with breast cancer (41 (54%) in the MU). This represented 4.2 cases of breast cancer per 1000 examinations. The number of cancers detected was significantly higher in women aged 60 to 69 years than in those aged 50 to 59 years (p < 0.001) or 40 to 49 years (p < 0.001). No difference was observed between women aged 40 to 49 years and those aged 50 to 59 years (p = 0.164). The proportion of tumors in the early (EC 0 and EC I) and advanced (CS III and CS IV) stages of development were 43.4% and 15.8%, respectively.
  
  
  CONCLUSIONS
  Preliminary results indicate that this mammography screening program is feasible for implementation in a rural Brazilian territory and favor program continuation.
authors.affiliation: Department of Cancer Prevention, Barretos Cancer Hospital, Rua Antenor Duarte Villella, 1331 -, Barretos, São Paulo, SP 14784-400, Brazil. raphael@hcancerbarretos.com.br
authors.forename: Raphael Luiz
authors.initials: RL
authors.lastname: Haikel
authors.forename: Edmundo Carvalho
authors.initials: EC
authors.lastname: Mauad
authors.forename: Thiago Buosi
authors.initials: TB
authors.lastname: Silva
authors.forename: Jacó Saraiva de Castro
authors.initials: JS
authors.lastname: Mattos
authors.forename: Luciano Fernandes
authors.initials: LF
authors.lastname: Chala
authors.forename: Adhemar
authors.initials: A
authors.lastname: Longatto-Filho
authors.forename: Nestor
authors.initials: N
authors.lastname: de Barros
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D008952:Mobile Health Units / Q000706:statistics & numerical data*; D009313:National Health Programs; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D016387:Women's Health; D055815:Young Adult