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Cross-national comparison of screening mammography accuracy measures in U.S., Norway, and Spain
- Source :
- European Radiology
- Publisher :
- Springer Nature
-
Abstract
- OBJECTIVE: To compare accuracy measures for mammographic screening in Norway, Spain, and the US. METHODS: Information from women aged 50-69 years who underwent mammographic screening 1996-2009 in the US (898,418 women), Norway (527,464), and Spain (517,317) was included. Screen-detected cancer, interval cancer, and the false-positive rates, sensitivity, specificity, positive predictive value (PPV) for recalls (PPV-1), PPV for biopsies (PPV-2), 1/PPV-1 and 1/PPV-2 were computed for each country. Analyses were stratified by age, screening history, time since last screening, calendar year, and mammography modality. RESULTS: The rate of screen-detected cancers was 4.5, 5.5, and 4.0 per 1000 screening exams in the US, Norway, and Spain respectively. The highest sensitivity and lowest specificity were reported in the US (83.1 % and 91.3 %, respectively), followed by Spain (79.0 % and 96.2 %) and Norway (75.5 % and 97.1 %). In Norway, Spain and the US, PPV-1 was 16.4 %, 9.8 %, and 4.9 %, and PPV-2 was 39.4 %, 38.9 %, and 25.9 %, respectively. The number of women needed to recall to detect one cancer was 20.3, 6.1, and 10.2 in the US, Norway, and Spain, respectively. CONCLUSIONS: Differences were found across countries, suggesting that opportunistic screening may translate into higher sensitivity at the cost of lower specificity and PPV. KEY POINTS: • Positive predictive value is higher in population-based screening programmes in Spain and Norway. • Opportunistic mammography screening in the US has lower positive predictive value. • Screening settings in the US translate into higher sensitivity and lower specificity. • The clinical burden may be higher for women screened opportunistically. This work was partially supported by grants from Instituto de Salud Carlos III FEDER (PI11/01296), BELE Study, the National Institutes of Health (T32CA09168), and the National Cancer Institute-funded Breast Cancer Surveillance Consortium (HHSN261201100031C). The collection of US cancer and vital status data used in this study was supported in part by several state public health departments and cancer registries
- Subjects :
- medicine.medical_specialty
Positive predictive value
Cross national comparison
genetic structures
Breast Neoplasms
030218 nuclear medicine & medical imaging
03 medical and health sciences
Mammographic screening
0302 clinical medicine
Medisinske Fag: 700::Klinisk medisinske fag: 750::Radiologi og bildediagnostikk: 763 [VDP]
Sensitivity
Predictive Value of Tests
Environmental health
medicine
Mammography
Humans
Mass Screening
Radiology, Nuclear Medicine and imaging
Breast
Variability
Mass screening
Early Detection of Cancer
Aged
Gynecology
medicine.diagnostic_test
Screening mammography
business.industry
Norway
Reproducibility of Results
Mama -- Radiografia
General Medicine
Middle Aged
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Radiologi og bildediagnostikk: 763
United States
3. Good health
Spain
Radiology Nuclear Medicine and imaging
030220 oncology & carcinogenesis
Specificity
Female
Radiology
Morbidity
business
Subjects
Details
- Language :
- English
- ISSN :
- 09387994
- Volume :
- 26
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- European Radiology
- Accession number :
- edsair.doi.dedup.....afddb5d9133cca78c7176a066a5cb05c
- Full Text :
- https://doi.org/10.1007/s00330-015-4074-8