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A proposal for short-term quality control in breast cancer screening
A L Verbeek1, M C Van den Ban, J H Hendriks
1Department of Social Medicine, Nijmegen University, The Netherlands.
British Journal of Cancer
|February 1, 1991
Summary
This study proposes monitoring breast cancer screening by focusing on reducing false positives, not just mortality. Early performance evaluation uses specificity, predictive value, and detection rates against set benchmarks.
Area of Science:
- Oncology
- Public Health
- Medical Imaging
Background:
- Breast cancer screening programs aim to reduce mortality.
- Current evaluation systems primarily focus on mortality reduction.
- A high number of false-positive results in screening can lead to unnecessary anxiety and procedures.
Purpose of the Study:
- To propose an alternative monitoring and evaluation system for breast cancer screening programs.
- To emphasize the prevention of excessive false-positive screening results.
- To enable early-phase performance measurement before interval cancer data is available.
Main Methods:
- Comparing the specificity of screening tests against established reference values.
- Evaluating the positive predictive value of screening tests.
- Assessing the detection rate of screening tests.
- Utilizing these metrics for early-phase program assessment.
Main Results:
- Proposed average reference values for the first screening round: 99.2% specificity, 40% positive predictive value, and 5.4/1000 detection rate.
- Method allows for early performance measurement.
- Specific measures are provided for age groups 45-49, 50-59, and 60-69.
Conclusions:
- The proposed system allows for early detection of performance issues in breast cancer screening programs.
- Focusing on false-positive rates alongside detection rates provides a more comprehensive evaluation.
- This approach facilitates timely program adjustments and improvements.