title: Factors associated with breast screening radiologists' annual mammogram reading volume in Italy.
abstract: OBJECTIVE
  Screening mammogram reading volume (SMRV) and total (screening and clinical) mammogram reading volume (TMRV) per year are strongly associated with the radiologist's diagnostic performance in breast cancer screening. The current article reports the prevalence and correlates of a SMRV and a TMRV ≥5000 among Italian breast screening radiologists.
  
  
  METHODS
  A questionnaire survey was carried out in 2013-2014 by the Italian Group for Mammography Screening (GISMa). The questionnaire included items of information for radiologist's experience-related characteristics and for facility-level factors supposedly associated with SMRV and TMRV. Multivariate analysis was performed using backward stepwise multiple logistic regression models.
  
  
  RESULTS
  Data for 235 radiologists from 51 local screening programmes were received. Of the 222 radiologists who were eligible, 133 (59.9 %) reported a SMRV ≥5000 and 163 (73.4 %) a TMRV ≥5000. Multivariate factors positively associated with both characteristics included: the number of years of experience reading mammograms; the percentage of total working time dedicated to breast imaging and breast care; the participation in diagnostic assessment; and the availability of digital tomosynthesis at facility. Full-time dedication to breast imaging and breast care was associated with the highest odds ratio for a SMRV and a TMRV ≥5000, i.e. 11.80 and 46.74, respectively, versus a percentage of time ≤50 %. An early (<2000) year of implementation of the screening programme and the availability of vacuum-assisted biopsy at facility were associated with a SMRV and, respectively, a TMRV ≥5000.
  
  
  CONCLUSIONS
  Increasing the proportion of radiologists with full-time dedication to breast imaging and breast care qualified as the most effective approach to improve SMRV and TMRV.
authors.affiliation: Senology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
authors.forename: Doralba
authors.initials: D
authors.lastname: Morrone
authors.affiliation: Epidemiology Unit, Centre for Cancer Prevention (CPO), Turin, Italy.
authors.forename: Livia
authors.initials: L
authors.lastname: Giordano
authors.affiliation: Mammography Screening Unit, Centre for Cancer Prevention (CPO), Turin, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Artuso
authors.affiliation: Clinical Senology and Mammography Screening Unit, Local Health Authority, Trento, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Bernardi
authors.affiliation: Regional Screening Coordinating Centre, Veneto Region, Venice, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Fedato
authors.affiliation: Regional Reference Centre for Breast Cancer Screening, Turin, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Frigerio
authors.affiliation: Epidemiology Unit, Local Health Authority, Lucca, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Giorgi
authors.affiliation: Department of Health, Emilia-Romagna Region, Bologna, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Naldoni
authors.affiliation: Senology Unit, Local Health Authority, Bologna, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Saguatti
authors.affiliation: Cancer Prevention Unit, Local Health Authority, Forlì, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Severi
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Taffurelli
authors.affiliation: Unité de Sénologie Chirurgicale, Hôpitaux Universitaires de Genève, Geneva, Switzerland.
authors.forename: Daniela
authors.initials: D
authors.lastname: Terribile
authors.affiliation: Clinical and Descriptive Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Ventura
authors.affiliation: Romagna Cancer Registry, Romagna Cancer Institute (IRST) IRCCS, Meldola, Forlì, Italy. lauro.bucchi@irst.emr.it.
authors.forename: Lauro
authors.initials: L
authors.lastname: Bucchi
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007558:Italy; D008327:Mammography / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011871:Radiology; D011795:Surveys and Questionnaires; D000078329:Workforce; D016526:Workload
keywords: Mammogram reading volume; Mammography; Questionnaire; Radiologist; Screening; Survey