title: Performance indicators evaluation of the population-based breast cancer screening programme in Northern Portugal using the European Guidelines.
abstract: OBJECTIVE
  To evaluate the first 10 years of operation of the population-based breast cancer screening programme implemented in the Northern Region of Portugal, using selected recommended standard performance indicators.
  
  
  METHODS
  Data from women aged 50-69 screened with two-view mammography, biennially, in the period 2000-2009, were included. Main performance indicators were compared with the recommended levels of the European Guidelines.
  
  
  RESULTS
  A total of 202,039 screening examinations were performed, 71,731 (35.5%) in the initial screening and 130,308 (64.5%) in the subsequent screening. Coverage rate by examination reached 74.3% of the target population, in the last period evaluated. Recall rates were 8.1% and 2.4% and cancer detection rates were 4.4/1000 and 2.9/1000 respectively, for initial and subsequent screenings. The breast cancer detection rate, expressed as a multiple of the background expected incidence was 3.1 in initial screen and 2.2 in subsequent screen. The incidence of invasive interval cancers met the desirable recommended levels both the first and second years since last screening examination, in the initial and subsequent screenings. Invasive tumours <15mm were 50.4% and 53.8% of the invasive cancers detected in initial and subsequent screenings. Less favourable size, grading and biomarkers expression were found in interval cancers compared to screen-detected cancers.
  
  
  CONCLUSIONS
  Breast cancer screening programme in the Northern Region of Portugal was well accepted by the population. Most of the performance indicators were consistent with the desirable levels of the European Guidelines, which indicate an effective screening programme. Future research should verify the consistency of some of these results by using updated information from a larger population.
authors: Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua de Jorge Viterbo, n° 228, 4050-313 Porto, Portugal; Epidemiology Unit, Portuguese Oncology Institute, Rua Dr. Antonio Bernardino de Almeida, 4200-072 Porto, Portugal. Electronic address: mjbento@icbas.up.pt.
authors: Maria José
authors: MJ
authors: Bento
authors: Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua de Jorge Viterbo, n° 228, 4050-313 Porto, Portugal. Electronic address: aggoncalves@icbas.up.pt.
authors: Guilherme
authors: G
authors: Gonçalves
authors: Portuguese Cancer League - North Branch, Porto Estrada Circunv. 6657, 4200-000 Porto, Portugal. Electronic address: anateresaaguiar@netcabo.pt.
authors: Ana
authors: A
authors: Aguiar
authors: Epidemiology Unit, Portuguese Oncology Institute, Rua Dr. Antonio Bernardino de Almeida, 4200-072 Porto, Portugal. Electronic address: clara.castro@ipoporto.min-saude.pt.
authors: Clara
authors: C
authors: Castro
authors: Portuguese Cancer League - North Branch, Porto Estrada Circunv. 6657, 4200-000 Porto, Portugal. Electronic address: presidente.nrnorte@ligacontracancro.pt.
authors: Vitor
authors: V
authors: Veloso
authors: Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal; Portuguese Cancer League - Centre Branch, Coimbra Rua Dr. Antonio Jose Almeida 329, 2°-pt 56, 3000-045 Coimbra, Portugal. Electronic address: vrodrigues@netcabo.pt.
authors: Vítor
authors: V
authors: Rodrigues
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008327:Mammography / Q000379:methods / Q000706:statistics & numerical data; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011174:Portugal / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D015397:Program Evaluation
keywords: Breast cancer; Mammography; Performance indicators; Population-based screening