Monitoring interval cancers in an Australian mammographic screening programme

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Abstract
Objective To report the interval cancer rate for BreastScreen Victoria. Design Electronic linkage of Breast Screen Victoria records with those of the Victorian Cancer Registry. Interval cancers were expressed as a proportion of the underlying incidence (proportional incidence), and the sensitivity as the number of screen detected invasive breast cancers divided by the total number of invasive breast cancers diagnosed in the screening interval. Setting Victoria, Australia where biennial screening is provided to women aged 40 and older. Subjects Victorian women aged 40–79 who attended first round screening in 1994 (103 023 women) and 1995 (107 057 women). Results The sensitivity of screening mammography for the two year interval increased with age (p for trend < 0.001) and was 49.4% in women aged 40–49, 68.6% in 50–59 year old women, 80.7% in 60–69 year old women, and 85.2% in women aged 70–79. The proportional incidence in the first year after screening was 59% in 40–49 year old women and 27% in women aged 50–69. In the second year the proportional incidence was 93% in 40–49 year old women and 54% in women aged 50–69. Conclusions Interval cancers comprise such a large proportion of the expected number of cancers in 40–49 year old women that the benefit of screening is likely to be low. For women aged 50–69, the proportional incidence found in this study was similar to those found in the UK programmes.

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