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[Alternatives to population screening for breast cancer. Is the chance detection useful?]
R Ciurana Misol1, S Calvet Junoy, C Espel Masferrer
1CAP La Mina, Sant Adrià del Besòs, Barcelona.
Objectives:
1. To evaluate the characteristics of the demand, coverage and acceptability of random detection of breast cancer at a health centre (HC) between January 1995 and December 1996. 2. To describe the cases of breast cancer diagnosed since the setting up in 1988 of random demands for screening mammographies.
Design:
Crossover study.
Setting:
La Mina Primary Care Centre, Barcelona.
Patients:
A sample of 340 women of a population of 2796 women between 45 and 75 with a clinical history at the HC were studied.
Measurements And Main Results:
The profile of women with neoplasms was: aged 59 +/- 8.5; 279 women attended, 273 medicine, 132 medicine and gynaecology, and 6 gynaecology. Mammographies requested were: 143 (118 through gynaecology, 12 medicine and 13 outside the centre), which was 51% of women who attended and 42% of the sample. The reason for mammography was screening (129) and symptoms (14). Screening mammographies actually done (acceptance) were 116 out of 129 (90%). Sample coverage was 34% (116/340); and 42% of the women who attended (116/279). Most studied age-group was 50-64 (coverage 45%, n = 176). 11 cases of breast cancer were diagnosed: age 54.3 +/- 9.1; 1 in situ, 3 < 10 mm, 2 between 10 and 20 mm, 4 > 20 mm, 1 without data. Diagnosis to treatment delay: 33.7 +/- 0 days. At time of writing 8 women were free of illness.
Conclusions:
Through random detection 34% coverage was achieved with good acceptance. Most neoplasms are diagnosed in their early stages. The general practitioner should be more attentive to periodic requests for mammographies.