title: Impact of the Introduction of Digital Mammography in an Organized Screening Program on the Recall and Detection Rate.
abstract: In 2012, the Reggio Emilia Breast Cancer Screening Program introduced digital mammography in all its facilities at the same time. The aim of this work is to analyze the impact of digital mammography introduction on the recall rate, detection rate, and positive predictive value. The program actively invites women aged 45-74 years. We included women screened in 2011, all of whom underwent film-screen mammography, and all women screened in 2012, all of whom underwent digital mammography. Double reading was used for all mammograms, with arbitration in the event of disagreement. A total of 42,240 women underwent screen-film mammography and 45,196 underwent digital mammography. The recall rate increased from 3.3 to 4.4% in the first year of digital mammography (relative recall adjusted by age and round 1.46, 95% CI = 1.37-1.56); the positivity rate for each individual reading, before arbitration, rose from 3 to 5.7%. The digital mammography recall rate decreased during 2012: after 12 months, it was similar to the recall rate with screen-film mammography. The detection rate was similar: 5.9/1000 and 5.2/1000 with screen-film and digital mammography, respectively (adjusted relative detection rate 0.95, 95% CI = 0.79-1.13). The relative detection rate for ductal carcinoma in situ remained the same. The introduction of digital mammography to our organized screening program had a negative impact on specificity, thereby increasing the recall rate. The effect was limited to the first 12 months after introduction and was attenuated by the double reading with arbitration. We did not observe any relevant effects on the detection rate.
authors.affiliation: Staff Programmazione e Controllo, AUSL Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy.|IRCCS, Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Campari
authors.affiliation: IRCCS, Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123, Reggio Emilia, Italy.|Servizio Interaziendale di Epidemiologia, AUSL Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
authors.affiliation: Dipartimento di Diagnostica per Immagini, IRCCS-Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Mori
authors.affiliation: Dipartimento di Diagnostica per Immagini, IRCCS-Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Ravaioli
authors.affiliation: Fisica Medica, IRCCS-Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Nitrosi
authors.affiliation: Dipartimento di Diagnostica per Immagini, IRCCS-Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Vacondio
authors.affiliation: IRCCS, Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123, Reggio Emilia, Italy. pamela.mancuso@ausl.re.it.|Servizio Interaziendale di Epidemiologia, AUSL Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy. pamela.mancuso@ausl.re.it.
authors.forename: Pamela
authors.identifier: http://orcid.org/0000-0003-1609-2440
authors.initials: P
authors.lastname: Mancuso
authors.affiliation: Staff Programmazione e Controllo, AUSL Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy.|IRCCS, Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cattani
authors.affiliation: Dipartimento di Diagnostica per Immagini, IRCCS-Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Pattacini
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data* / Q000639:trends; D008403:Mass Screening / Q000592:standards / Q000706:statistics & numerical data*
keywords: Breast cancer; Cancer screening; Digital mammography; Mammography; Specificity