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At least 19 recordsLinked to original sources
PubMed2001

Gonorrhoea screening in general practice: perceived barriers and strategies to improve screening rates.

OBJECTIVE: To investigate perceived barriers to gonorrhoea screening in general practice and suggest strategies to overcome them. DESIGN: Questionnaire-based survey. SETTING AND PARTICIPANTS: All 47 general practitioners (GPs) authorised to prescribe subsidised HIV drugs under the Pharmaceutical Benefits Scheme in inner, eastern and northern Sydney. MAIN OUTCOME MEASURES: Agreement on a five-point Likert scale with statements about attitudes and practices in relation to gonorrhoea screening of homosexually active men, and views on how testing rates could be increased. RESULTS: 32 GPs responded (68%). Perceived barriers to gonorrhoea testing included structural measures imposed by the Federal Government to limit pathology testing by GPs (the Medicare "three-test rule") (17 respondents agreed or strongly agreed), pressure from the Health Insurance Commission (HIC) to minimise pathology testing (15), concerns about confidentiality of notification procedures (8), clinical time pressure (8), and concerns about recriminations against HIV patients with gonorrhoea (6). Suggested measures to increase testing were education of gay men to request testing (25), relaxation of the three-test rule (25), easier tests (23), anonymous notification procedures, review of HIC policy on screening, and training about testing (21 each). CONCLUSIONS: Sydney GPs with high HIV caseloads perceived structural barriers to gonorrhoea testing and supported a range of achievable strategies to overcome these. As the sustained epidemic of gonorrhoea in Sydney may be directly promoting HIV transmission, these strategies should be considered urgently.

Adult↗
PubMed2006

Chlamydia screening in at-risk adolescent females: an evaluation of screening practices and modifiable screening correlates.

PURPOSE: To identify modifiable correlates of chlamydia screening that could offer intervention targets to enhance screening. METHODS: We surveyed a representative sample of primary care providers (n = 186) at an integrated healthcare delivery system to document their self-reported adherence to annual screening of sexually-active adolescents and to identify specific, modifiable constructs that were correlated with annual chlamydia screening. To cross-validate providers' self-report, we also used automated data to examine adolescent screening in an anonymous sample of primary care providers (n = 143). RESULTS: Forty-two percent of providers reported annual chlamydia screening of sexually-active adolescents. Univariate correlates of annual screening were: provider type (non-physician) (p = .01), female gender (p = .001), fewer years of clinical experience (p = .001), greater perceived knowledge about chlamydia (p = .001), greater confidence across a range of screening-related activities (p < or = .01), greater comfort recommending screening for sexually transmitted diseases (p = .001), and greater perceived patient comfort discussing sexual issues (p < .01). In multivariate analyses, providers' perceived knowledge, confidence, comfort, and perceived patient comfort continued to be significantly associated with annual chlamydia screening after controlling for other relevant provider characteristics. Self-reported screening practices were consistent with observed screening rates in the anonymous provider sample. CONCLUSIONS: Routine chlamydia screening among asymptomatic, at-risk adolescent females could be enhanced through additional intervention targeting specific provider attitudes and beliefs about chlamydia screening.

Adolescent↗
PubMed2003

Multiple-marker screening in human immunodeficiency virus-positive pregnant women: Screen positivity rates with the triple and quad screens.

OBJECTIVE: The study was undertaken to determine the screen-positive rates of multiple-marker screening tests in pregnant women who are positive for human immunodeficiency virus (HIV) at our institution for open neural tube defects and aneuploidy, for both triple (alpha-fetoprotein, human chorionic gonadotropin [hCG], unconjugated estriol) and quad (alpha-fetoprotein, hCG, unconjugated estriol, inhibin A) screens, and to compare these rates with a matched control group. STUDY DESIGN: A 1:1 matched case-control study was performed comparing multiple marker screening test results in 34 HIV-positive women with age- and race-matched HIV-negative controls. Individual serum markers and screen positive rates for both the triple and quad screens were compared among the cases and controls. RESULTS: In each group, there were 19 women with triple screens and 15 with quad screens. Serum hCG multiples of the median were significantly higher in the HIV-positive compared with the HIV-negative women (P=.033). There was no difference in screen positive rates between the cases and controls using the triple screen, but there was a significantly higher overall screen positive rate in the HIV-positive group when the quad screen was used (33% vs 7%, P=.046). CONCLUSION: There is a significantly higher rate of overall quad screen positivity on multiple-marker screening among HIV-positive women compared with a matched control group.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Towards comprehensive population-based screening for diabetic retinopathy: operation of the North Wales diabetic retinopathy screening programme using a central patient register and various screening methods.

OBJECTIVES: To examine whether population-based retinopathy screening using a central diabetes register and employing various screening methods can achieve a high degree of population coverage to meet National Screening Committee (NSC) targets. To identify the main barriers to achieving comprehensive population coverage. To analyse referrals to ophthalmology and their outcome as a measure of previously unmet need. To assess the influence of modality of screening. SETTING: Three local health board areas in North Wales. METHODS: Establishment of a district diabetes register to hold records of all patients and subserve call-recall of general practitioner (GP) sole-care patients for screening by optometrists or digital photography. Hospital attenders were screened in diabetic clinic by direct ophthalmoscopy. Data were collected for years 1 and 2 of operation of the scheme. RESULTS: The system held a screening record for 86% of diabetic patients after year 1 and 93% after year 2. Failure to attend was the major barrier to comprehensive population screening, but this improved in year 2 (P<0.001). Both optometrists and photography identified substantial unmet need: 1% of all GP sole-care patients required immediate laser treatment. Photography was more sensitive than optometrist screening, but the additional retinopathy identified was mostly minor not requiring treatment. CONCLUSIONS: Lack of screening is much more important than modality of screening as a cause of missed sight-threatening retinopathy. A central, district-based patient register system identifies those patients not screened for further follow-up and can produce a high level of population coverage, close to NSC targets. Such schemes are needed, particularly to support primary care diabetes management.

Diabetic Retinopathy↗
PubMed1998

Nation-wide breast cancer screening in The Netherlands: results of initial and subsequent screening 1990-1995. National Evaluation Team for Breast Cancer Screening.

Based on an extensive cost-effectiveness analysis, the Dutch nation-wide breast cancer screening programme started in 1990, providing a biennial screen examination to women aged 50 to 69 years. The programme is monitored by the National Evaluation Team, which annually collects tabulated regional evaluation data to determine performance indicators. This study presents (trends in) the outcomes of initial and subsequent screening rounds, 1990-1995, and compares them to the predictions of the cost-effectiveness-analysis. Up to 1996, 88% of the target population was covered by the programme and more than 2.4 x 10(6) women were invited. The overall attendance rate was 77.5% with little differences between screening rounds and age groups; the highest rate was found in non-urbanised areas (82.4%). Of 1,000 initially (and 2 years thereafter) screened women, 13.4 (6.6) were referred for further investigation, 9.7 (4.4) were biopsied and 6.4 (3.4) had breast cancer. The positive predictive values of screen test and biopsy were 47% (51%) and 66% (78%), respectively. DCIS was diagnosed in 0.9 (0.5) and invasive cancers < or = 10 mm in 1.5 (1.0) per 1,000 screens. Lymph node metastases were found in 28% (24%) of the invasive cancers. Except the increasing attendance, which was much higher than expected, the results were fairly constant over the years. Contrary to initial screens, the results of subsequent screens did not fulfil expectations with regard to breast cancer detection and tumour size distribution. We conclude that the nation-wide screening programme is being implemented successfully. Given the results, the programme should contribute to a substantial breast cancer mortality reduction in the future. The discrepancy between observed and expected results in subsequent screens has to be watched carefully.

Age Factors↗
PubMed2005

Prostate Cancer Screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial: findings from the initial screening round of a randomized trial.

BACKGROUND: The benefit of screening for prostate cancer using prostate-specific antigen (PSA) testing and digital rectal examination (DRE) is uncertain and is under evaluation in a randomized prospective trial, the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Although the final results are several years away, the initial round of screening is complete. We describe the population enrolled in the PLCO trial, their baseline PSA and DRE screening results, and diagnostic follow-up results during the first year of follow-up. METHODS: A total of 38,350 men were randomly assigned to the screening arm of the PLCO trial from November 1993 through June 2001. Men were advised to seek diagnostic follow-up from their primary care provider if their DRE was suspicious for cancer and/or if their serum PSA level was higher than 4 ng/mL. PLCO trial staff obtained records related to diagnostic follow-up. RESULTS: Compliance with both screening tests was high (more than 89%). At screening, 7.5% of men had a positive DRE (i.e., suspicious for cancer) and 7.9% had a PSA level higher than 4 ng/mL. Of the men with positive screening tests, 74.2% underwent additional diagnostic testing, and 31.5% underwent a prostatic biopsy within 1 year. Overall, 1.4% of the men in the screening arm were diagnosed with prostate cancer, the majority of whom had clinically localized cancer. These compliance, biopsy, and cancer detection rates appear to be representative of contemporary practice patterns. CONCLUSION: The PLCO trial is evaluating PSA- and DRE-based screening for prostate cancer in a clinically valid manner. Whether such screening will result in a reduction of prostate cancer mortality cannot be answered until the randomized comparison is completed.

Aged↗
PubMed2005

[The attendance of the first screening round (2002-2003) of the Hungarian organized breast cancer screening program and its effect on the number of diagnostic and screening mammography].

AIM: Organised, nationwide screening for breast cancer with mammography in the age group 45-65 years with 2 years screening interval started in Hungary in January 2002. The aim of this study is to analyze the attendance rate of breast screening programme, including the analysis of the ratio of screening and diagnostic mammography examinations. DATA AND METHODS: The data derive from the financial database of the National Health Insurance Fund Administration (NHIFA) covering the period 2000-2003. The ratio of women was calculated in the age group 45-65 years having either a screening mammography or a diagnostic mammography. The analysis was carried out for the years 2000-2001 (mainly opportunistic screening) before and 2002-2003 after the implementation of nationwide organized programme. RESULTS: In the years 2000-2001 7,26% of the women aged 45-65 had an opportunistic screening mammography while in 2002-2003 33,95% of the target population had screening mammography within the organized programme. During the same periods 19,67% (2000-2001) and 22,05% (2002-2003) of women aged 45-65 had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 25,85% (2000-2001) to 53,46% (2002-2003). CONCLUSIONS: The attendance of the Hungarian organized breast cancer screening programme - compared to the previous period before the implementation of the organized screening programme - is promising, although to achieve the expected results in mortality decrease a further improvement of the uptake is necessary.

Breast Neoplasms↗
PubMed2003

Evaluation of OECD screening tests 421 (reproduction/developmental toxicity screening test) and 422 (combined repeated dose toxicity study with the reproduction/developmental toxicity screening test).

The Advisory Committee on Existing Chemicals (BUA) of the Federal Republic of Germany convened a panel with expertise in reproductive and developmental toxicology to evaluate the OECD Screening Tests 421 (Reproduction/Developmental Toxicity Screening Test) and 422 (Combined Repeated Dose Toxicity Study with the Reproduction/Developmental Toxicity Screening Test) with respect to their ability to unmask any potential toxic effects on reproduction. The original assignment for that panel was to "validate" those screening tests. However, the panel members recognized beforehand that this was actually an impossible task because of lack of a sufficient database. Only five chemicals with known reproductive toxicity had been examined following the OECD Screening Test Guidelines 421 or 422. A comparison of these test results with those of the definitive OECD Test Guidelines 414, 415, 416, or additional investigations could, therefore, only have been made with this very limited number of chemicals that had also undergone evaluation by one of the test guidelines cited. In each case biological properties relevant to reproductive toxicity were also indicated by the OECD Screening Tests 421 or 422. This communication reviews the main differences in study design of OECD Screening Test Guidelines 421 and 422 compared to those definitive test guidelines of similar study design for reproduction or developmental toxicity (especially with the one-generation study, OECD Test Guideline 415). The very limited possibilities of detecting late postnatal and postlactational manifestations are emphasized, as is the low statistical power of the OECD Screening Tests 421 and 422. Furthermore, the very limited ability to unmask teratogenicity is delineated. The outcome of screening tests was evaluated based on the results of 57 studies conducted according to the OECD Test Guideline 421 or 422. The test results were categorized according to the incidence of toxic effects on reproduction in the parent animals or their offspring and related to general toxic effects. Based on the ranking of these results, recommendations regarding setting rational priorities for further evaluations of existing chemicals' reproductive hazards are made. In general, the reviewer panel supports the OECD position that the screening tests are useful for initial hazard assessment and can contribute to the decision-making process on setting priorities for further test requirements. The panel also agrees with the OECD statement that the OECD Screening Tests 421 and 422 are neither an alternative to definitive tests (i.e., OECD Test Guidelines 414, 415, and 416) nor are they intended as their replacement.

Abnormalities, Drug-Induced↗
PubMed1994

The value of Medicare statistics in monitoring Pap smear screening. Screening versus non-screening smears: the role of the laboratory.

In November 1991 separate Medicare item numbers were introduced to distinguish screening from non-screening cervical smears for the purposes of monitoring the screening programme. Referring doctors are now expected to indicate the appropriate item number on the request form accompanying the Pap smear. To test compliance with this requirement, we examined 1000 consecutive request forms for cervical smears received in August 1993. We found that 22.7% had no item number indicated and that for a further 10.4% the item number given appeared to be incorrect. As the account issued by the laboratory must show an item number the ultimate responsibility for the choice of the item number rests with the laboratory. Using the guidelines supplied by Medicare, we formulated detailed criteria to classify smears as screening or non-screening, based on the patient's past smear history and/or clinical information provided by the referring doctor. Applying these criteria to cervical smears received in this laboratory in 1993 resulted in 70% being classified as screening and 30% as non-screening smears. Analysis of the cytological predictions for these smears showed substantially higher rates for all grades of abnormalities in the non-screening smears, thus lending support to the validity of our classification system. We conclude that classifying smears into screening and non-screening categories provides valuable information for statistical and quality assurance purposes but can only be useful for monitoring purposes if the criteria for assigning smears are applied consistently by all doctors and laboratories.

Australia↗
PubMed1998

Breast cancer screening programmes in 22 countries: current policies, administration and guidelines. International Breast Cancer Screening Network (IBSN) and the European Network of Pilot Projects for Breast Cancer Screening.

BACKGROUND: Currently there are at least 22 countries worldwide where national, regional or pilot population-based breast cancer screening programmes have been established. A collaborative effort has been undertaken by the International Breast Cancer Screening Network (IBSN), an international voluntary collaborative effort administered from the National Cancer Institute in the US for the purposes of producing international data on the policies, funding and administration, and results of population-based breast cancer screening. METHODS: Two surveys conducted by the IBSN in 1990 and 1995 describe the status of population-based breast cancer screening in countries which had or planned to establish breast cancer screening programmes in their countries. The 1990 survey was sent to ten countries in the IBSN and was completed by nine countries. The 1995 survey was sent to and completed by the 13 countries in the organization at that time and an additional nine countries in the European Network. RESULTS: The programmes vary in how they have been organized and have changed from 1990 to 1995. The most notable change is the increase in the number of countries that have established or plan to establish organized breast cancer screening programmes. A second major change is in guidelines for the lower age limit for mammography screening and the use of the clinical breast examination and breast self-examination as additional detection methods. CONCLUSION: As high quality population-based breast cancer screening programmes are implemented in more countries, they will offer an unprecedented opportunity to assess the level of coverage of the population for initial and repeat screening, evaluation of performance, and, in the longer term, outcome of screening in terms of reduction in the incidence of late-stage disease and in mortality.

Adult↗
PubMed1986

Screening for squamous cervical cancer: duration of low risk after negative results of cervical cytology and its implication for screening policies. IARC Working Group on evaluation of cervical cancer screening programmes.

A collaborative study of screening programmes in eight countries was performed to estimate the risks of cervical cancer associated with different screening policies. Most of the data came from centrally organised screening programmes. Relative protection was higher in women who had had two or more negative results of screening tests than in those who had had only one negative smear, particularly in the first five years after the last test. There was little difference in the protection afforded by screening every year compared with every three years, but screening only once every five or 10 years offered appreciably less protection. The age of the women did not affect the sensitivity of the test or the sojourn time of the disease (the length of the detectable preclinical phase during which abnormal cytology could be picked up if a smear were taken); invasive cancer in women under 25 was rare. Centrally organised screening programmes were more effective than uncoordinated screening. Screening programmes should be aimed principally at women aged 35-60 but should start some years before the age of 35, and the intervals between screening should be three years or less.

Adult↗
PubMed1993

Different characteristics of neuroblastomas in cases found by mass screening and non-screening: evaluation of mass screening for neuroblastoma in Kitakyushu City.

Neuroblastoma accounts for 24 of 109 patients who have been managed by the pediatric tumor outpatient clinic of our university hospital. Among the malignant solid tumors, neuroblastomas are the most numerous. We investigated neuroblastomas found by mass screening oncologically and epidemiologically. Up until March 31, 1991, seven cases were detected from 64,885 infants who received mass screening by the Kitakyushu City System which we had introduced in 1985. This system is based on an individual health survey program for infants in the city. Six of seven cases found by the screening were treated in our department. None of them, including stage III and stage IV cases, showed any conventional risk factors such as high serum levels of neuron specific enolase, ferritin, amplification of N-myc gene, nor cytogenetic abnormalities. Histopathological studies revealed that ganglioneuroblastoma was observed in 9 of 13 cases over one year of age, whereas it was observed only in two screened cases out of 11 cases under one year of age. According to the classification of Shimada et al., there was one stroma-rich tumor, which is rare in infants and usually a matured type, in the screened cases. Interestingly, another one of the six screened cases regressed spontaneously without any treatment. These cases suggested that some neuroblastomas in the process of maturation or spontaneous regression could be detected by mass screening. On the other hand, 9 of 13 non-screened cases over one-year-old died. Although mass screening at six months of age decreased the mortality rate by neuroblastoma in infancy, the prognosis of neuroblastoma in patients over one-year-old remained still poor. Mass screening should be carried out in a health survey program at one year and six months of age in order to improve the outcome.

Child↗
PubMed2001

To screen or not to screen: the issue of breast cancer screening in older women.

INTRODUCTION: The United States Preventive Services Task Force (USPSTF) recommends that women aged 50-69 receive timely breast cancer screening, but does not make a recommendation for women aged 70 and older. Our purpose is to assess the relationship between age and breast cancer screening trends, and to consider the issue of breast cancer screening of women 70 years of age and older in light of demographics, disease burden, life expectancy, and activity level. METHODS: Data were analyzed from the state-based Behvioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS) on breast cancer screening practices and activity limitation status of women 50 and older. RESULTS: The percentage of women who reported receiving mammography and clinical breast examination within two years was lower among older women compared with younger women, and the gap has widened over time. In 1991-92, 61.4% of women 50-69 received screening within two years, compared to 49.5% of women 70 and above, while in 1997-98, the percentages were 71.1 and 56.7, respectively. Among both age groups and in both time periods, those unable to perform a major activity of daily living were less likely to report receiving mammography within two years than those with no limitation, and the gap was much wider in the elderly. Most (62.7%) women 70 and older reported having no activity limitation; only 5.5% reported being unable to perform a major activity. DISCUSSION: These results suggest that elderly women are less likely than younger women to receive timely breast cancer screening. The USPSTF does not recommend continued screening in elderly women because most studies of breast cancer efficacy included inadequate numbers of these women. Few, if any, studies have yielded evidence that screening is ineffective in women 70 and over. Given the higher breast cancer incidence and mortality seen in elderly women, as well as the increased life expectancy with little or no activity limitation seen among today's elderly, consideration should be given to including elderly women in the recommendation to receive timely breast cancer screening. Since surgical and adjuvant therapy for breast cancer in older women has less complications than therapy for other cancers of the elderly, the cost-benefit ratio for breast cancer screening in this age group may prove to be more promising.

Activities of Daily Living↗
PubMed2001

Screening for trisomy 21: the significance of a positive second trimester serum screen in women screen negative after a nuchal translucency scan.

Screening of pregnancies for trisomy 21 is now an accepted part of antenatal care. Measurement of fetal nuchal translucency in the first trimester and analysis of maternal serum biochemistry in the second trimester are both established methods of screening. The performance characteristics of both tests in an unselected population are well described and the choice of test offered is usually determined by local policy and resources. We present data from a screening programme offering women with a low risk result from nuchal translucency measurement a second trimester serum screen. There were eight cases of trisomy 21 in the 2683 women screened, all of which presented with a high-risk nuchal screen result. Serum screening of 1057 women who screened negative by nuchal translucency gave 46 high-risk results, all of which were, therefore, false positive for trisomy 21. Second trimester biochemistry screening following a negative nuchal translucency screen did not increase the detection of trisomy 21.

Journal Article↗
PubMed1999

Biomolecular-chemical screening: a novel screening approach for the discovery of biologically active secondary metabolites. I. Screening strategy and validation.

Chemical screening using thin-layer chromatography and various staining reagents offers the opportunity to visualize an almost complete picture of a microbial secondary metabolite pattern (metabolic finger-print). A thorough application of this strategy resulted in a number of biologically active new secondary metabolites, although the screening strategy is per se not correlated to any biological activity. In the present paper we report on a novel approach called biomolecular-chemical screening which combines the chemical screening strategy with binding studies of biological relevance. Making use of thin-layer chromatography (TLC) and subsequent staining, biomolecular-chemical screening allows to examine binding properties of low molecular weight metabolites to certain bio-macromolecules. The screening strategy itself, as well as independent validation of the results using DNA as selected bio-macromolecule are presented. The biomolecular-chemical screening method is useful to screen binding behaviour towards DNA of both, pure metabolites by one-dimensional TLC, and crude extracts by two-dimensional TLC. Investigation of pure secondary metabolites as well as screening of crude microbial extracts and new secondary metabolites obtained with this screening strategy are presented in accompanying papers.

Bacteria↗
PubMed1977

A controlled trial of multiphasic screening in middle-age: results of the South-East London Screening Study. The South-East London Screening Study Group.

The results of a controlled trial of multiphasic screening in general practice are presented. In 1967, 7,229 individuals aged between 40 and 64 years were randomly allocated into either a Screening or Control group. The Screening group were invited to attend two screening sessions held about two years apart, while the Control group continued to receive conventional medical care. Both groups were then invited to undergo a health survey in 1972-73 which revealed no significant differences in morbidity between the two groups. Careful follow-up permitted detailed Screening-Control comparisons of various outcome measures--consultation and hospital admission rates, certified sickness absence from work, and mortality. Nine years after the initial screening, no significant differences were found between the two groups in any of the outcome measures. It is estimated that a similar screening programme for the entire middle-aged UK population would cost 142 pounds million at 1976 prices.

Aged↗
PubMed1999

Large-scale HCV RNA screening in first-time blood donors: the first step towards genomic screening of blood donations. HCV RNA Screening Study Group.

BACKGROUND AND OBJECTIVES: Individual genomic screening for viruses in blood donations is becoming increasingly pressing as an alternative to pool testing to improve the safety of the blood supply. MATERIALS AND METHODS: To determine the feasibility and, possibly, efficacy of genomic screening for hepatitis C virus (HCV) in the blood service setting, a representative population of first-time blood donors was screened individually with a semi-automated genomic amplification assay for HCV RNA. First-time blood donors in two blood centres in the United Kingdom were screened in parallel for anti-HCV and HCV RNA by RT-PCR. RESULTS: 8, 417 serum samples were screened. A 99.95% specificity was observed and one anti-HCV-positive, HCV-RNA-positive donation was found. No seronegative HCV-RNA-positive donations were detected. CONCLUSIONS: These results are consistent with the low prevalence of HCV infection in blood donors from the London area and demonstrate the high level of performance of the individual genomic screening method used in this study. When fully automated, such a method would be a highly suitable candidate for routine, automated genomic screening of HCV and, subsequently, of other pathogenic blood-borne viruses.

Autoanalysis↗
PubMed2005

Ten years of breast screening in the Nova Scotia Breast Screening Program, 1991-2001. experience: use of an adaptable stereotactic device in the diagnosis of screening-detected abnormalities.

OBJECTIVE: To evaluate and present 10-year outcomes of the Nova Scotia Breast Screening Program (NSBSP), a population-based screening program in the province of Nova Scotia, Canada, total population 900 000. SETTING: Organized Breast Screening Program in Nova Scotia, Canada. METHODS: Rates of participation, abnormal referrals, cancer detection rates, and benign:malignant (B:M) rates for core biopsy and surgical biopsy were calculated for asymptomatic women receiving a mammogram through the NSBSP 1991-2001. RESULTS: Of 192 454 mammograms performed on 71 317 women, 33% were aged 40 to 49 years, 39% aged 50 to 59 years, 23% aged 60 to 69 years, and 5% aged 70 years and over. Cancer detection rate increased in each age group respectively: 3.7, 5.8, 9.7, and 13.5 per 1000 population on first-time screens. The positive predictive value of an abnormal screen increased with increasing age groups. Benign breast surgery decreased with increased use of needle core breast biopsy (NCBB). Open surgery decreased from 25 to 6 surgeries per 1000 screens. Of 1519 open surgical procedures (1328 women), 878 cancers were removed, with 37% 10 mm or less, and 61% 15 mm or less. In 613 women in whom the node status was assessed, 79% were negative. CONCLUSION: A quality screening program incorporating NCBB in the diagnostic work-up is effective in the early detection of breast cancer and results in less open surgery, particularly in younger women.

Adult↗