German mammography screening program: program sensitivity between 2010 and 2016 estimated based on German health...

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Program sensitivity is a critical quality indicator for mammography screening programs (MSP).
• Estimating MSP sensitivity typically requires linking screening and cancer registry data, which is limited in Germany.
• This study explores using health claims data to estimate MSP sensitivity.

Purpose of the Study:

• To assess the feasibility of using German health claims data to estimate mammography screening program sensitivity.
• To determine program sensitivity and cancer detection rates within the German MSP using claims data.

Main Methods:

• Utilized data from BARMER, a large German statutory health insurance fund (approx. 9 million members).
• Included women aged 50-69 undergoing non-initial screening mammography between 2010-2016, with a two-year follow-up.
• Estimated rates of screen-detected cancers, interval cancers, and overall program sensitivity.

Main Results:

• Analyzed 1,992,287 screening examinations in 212,400–303,667 women annually.
• Age-standardized program sensitivity ranged from 69.9% to 71.7% during the study period.
• Rates of screen-detected breast cancer were 4.6–5.3 per 1,000 examinations, with interval cancer rates of 0.6–1.4 per 1,000.

Conclusions:

• Results from health claims data are plausible and consistent with existing estimates from data linkage.
• German health claims data is a valuable resource for estimating mammography screening program quality indicators.
• The estimated quality indicators align with European Guidelines for mammography screening.