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Dutch digital breast cancer screening: implications for breast cancer care.
- Source :
-
European journal of public health [Eur J Public Health] 2012 Dec; Vol. 22 (6), pp. 925-9. Date of Electronic Publication: 2011 Dec 08. - Publication Year :
- 2012
-
Abstract
- Background: In comparison to other European population-based breast cancer screening programmes, the Dutch programme has a low referral rate, similar breast cancer detection and a high breast cancer mortality reduction. The referral rate in the Netherlands has increased over time and is expected to rise further, mainly following nationwide introduction of digital mammography, completed in 2010. This study explores the consequences of the introduction of digital mammography on the balance between referral rate, detection of breast cancer, diagnostic work-up and associated costs.<br />Methods: Detailed information on diagnostic work-up (chart review) was obtained from referred women (nā=ā988) in 2000-06 (100% analogue mammography) and 2007 (75% digital mammography) in Nijmegen, the Netherlands.<br />Results: The average referral rate increased from 15 (2000-06) to 34 (2007) per 1000 women screened. The number of breast cancers detected increased from 5.5 to 7.8 per 1000 screens, whereas the positive predictive value fell from 37% to 23%. A sharp rise in diagnostic work-up procedures and total diagnostic costs was seen. On the other hand, costs of a single work-up slightly decreased, as less surgical biopsies were performed.<br />Conclusion: Our study shows that a low referral rate in combination with the introduction of digital mammography affects the balance between referral rate and detection rate and can substantially influence breast cancer care and associated costs. Referral rates in the Netherlands are now more comparable to other countries. This effect is therefore of value in countries where implementation of digital breast cancer screening has just started or is still under discussion.
- Subjects :
- Aged
Biopsy
Breast Neoplasms economics
Breast Neoplasms mortality
Cost-Benefit Analysis
Early Detection of Cancer economics
Early Detection of Cancer methods
Female
Humans
Mammography economics
Mass Screening economics
Mass Screening statistics & numerical data
Middle Aged
Netherlands epidemiology
Outcome Assessment, Health Care
Predictive Value of Tests
Program Evaluation
Referral and Consultation economics
Referral and Consultation trends
Survival Rate
Breast Neoplasms diagnosis
Delivery of Health Care economics
Early Detection of Cancer statistics & numerical data
Mammography methods
Referral and Consultation statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1464-360X
- Volume :
- 22
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- European journal of public health
- Publication Type :
- Academic Journal
- Accession number :
- 22158996
- Full Text :
- https://doi.org/10.1093/eurpub/ckr170