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Analysis of proportional incidence and review of interval cancer cases observed within the mammography screening programme in Trento province, Italy

Analisi dell’incidenza proporzionale e revisione dei casi di carcinoma di intervallo osservati durante il programma di screening mammografico svolto in Italia nella provincia di Trento

  • Breast Radiology / Senologia
  • Published:
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Abstract

Purpose

The aim of this study was to assess the performance of the mammography screening programme in Trento Province, Italy, by analysing the interval cancers (IC) observed from 2001 to 2008.

Material and methods

IC were identified by linking screening archives with local cancer registry and pathology archives as well as with hospital discharge records. Proportional incidence was determined according to breast cancers expected in the absence of screening, estimated on the basis of patients/year at risk and age-specific incidence. The review of screening mammograms preceding ICs was performed by an external (three radiologists) and an internal (five radiologists) panel and aimed at assessing the proportion of IC reviewed as screening errors. Results were compared with European Community (EC) recommended standards.

Results

IC proportional incidence was 15.90% for the first year (EC standard <30%) and 25.77% for the second year (EC standard <50%) of the interval. At external review, 18.4% of cases were reviewed as screening errors (identified by at least two of three reviewers), whereas at internal review (identified by at least three of five reviewers) it was 17.4% (EC standard <20%). No significant difference was observed between external and internal review (mean recall rate 8.3% vs. 9.0%; mean identification rate 19.7% vs 19.6%).

Conclusions

The study confirms good performance of the mammography screening programme in Trento Province, Italy. Comparable results of external and internal reviews suggest that the latter, no doubt easier to be implemented, might be adopted as a routine procedure to assess this early efficacy indicator.

Riassunto

Obiettivo

L’obiettivo di questo studio è valutare la performance del programma di screening in provincia di Trento attraverso l’analisi dei carcinomi di intervallo (CI) osservati nel periodo 2001–2008.

Materiali e metodi

I CI sono stati identificati per incrocio dell’archivio di screening con quelli del registro tumori e delle anatomie patologiche locali, e con le schede di dimissione ospedaliera. L’incidenza proporzionale dei CI è stata valutata rispetto ai carcinomi attesi in assenza di screening, calcolati sulla base dei pazienti/anno a rischio e alle incidenze età specifiche. La revisione dei radiogrammi di screening precedenti i CI è stata operata da un panel di radiologi esterno (3 radiologi) e uno interno (5 radiologi), per la definizione del tasso di CI valutati come errori di screening. I risultati sono stati confrontati con gli standard di riferimenti raccomandati dalla Comunità Europea (CE).

Risultati

Il tasso proporzionale di CI è stato del 15,90% nel primo anno dell’intervallo (standard CE<30%) e del 25,77 % nel secondo anno (standard CE<50%). Alla revisione esterna, la frazione di casi rivalutati come errori di screening (identificati da almeno 2 su 3 revisori) è stata del 18,4%: alla revisione interna (almeno 3 su 5 revisori) è stata del 17,4% (standard CE<20%). Non si è rilevata differenza significativa nella performance (tasso medio di positività 8,3% vs. 9,0%, tasso medio di identificazione 19,7% vs. 19,6%) tra revisione esterna e interna.

Conclusioni

Lo studio conferma la buona performance del programma di screening mammografico in provincia di Trento. L’apparente equivalenza della revisione esterna e interna suggerisce che la seconda, certamente più agevole, possa essere impiegata nella routine per la definizione di questo indicatore precoce di efficacia.

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Authors and Affiliations

  1. U.O. Senologia Clinica e Screening Mammografico, Dipartimento di Radiodiagnostica, APSS, Trento, Italy

    M. Pellegrini, D. Bernardi, S. Di Michele, P. Tuttobene, C. Fantò & M. Valentini

  2. Dipartimento di Radiodiagnostica, APSS, Trento, Italy

    P. Peterlongo

  3. Centro di Prevenzione Senologica (CPS), PO Marzana, ULSS 20, Verona, Italy

    F. Caumo & S. Ciatto

  4. CRR, Centro di Riferimento Regionale per lo Screening Mammografico, Torino, Italy

    A. Frigerio

Authors
  1. M. Pellegrini
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  2. D. Bernardi
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  3. S. Di Michele
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  4. P. Tuttobene
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  5. C. Fantò
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  6. M. Valentini
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  7. P. Peterlongo
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  8. F. Caumo
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  9. A. Frigerio
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  10. S. Ciatto
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Correspondence to S. Ciatto.

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Pellegrini, M., Bernardi, D., Di Michele, S. et al. Analysis of proportional incidence and review of interval cancer cases observed within the mammography screening programme in Trento province, Italy. Radiol med 116, 1217–1225 (2011). https://doi.org/10.1007/s11547-011-0711-8

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  • DOI: https://doi.org/10.1007/s11547-011-0711-8

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