The early breast cancer detection program of the Israel Cancer Association: a retrospective evaluation

Between 1 January 1965 and 31 December 1975 82,262 women visited an early breast cancer detection center at least once. Subsequent to the visit 1,295 women were found to have breast cancer. The observed survival of these 1,295 patients (the study group) was compared to that of two control groups: 1) all breast cancer patients diagnosed in Israel in the five years preceding the start of the Early Detection program (2,402), and 2) all breast cancer patients diagnosed while the Early Detection Program was in progress, but who never visited an early detection center (6,315). The stage distribution of the study group showed significantly more early-stage cases than controls. The observed survival of the study group was significantly longer than that of the control groups, irrespective of mode of referral of the former to the Early Detection Program (by invitation, self-referral, or doctor-referral). The observed survival of study patients was longer than that of controls within each stage group, although most differences were not statistically significant and relatively large number of "unknowns" in key variables may have introduced bias into the study results. Future programs of the Israel Cancer Association should have clearly stated and measurable objectives and built-in mechanisms for ongoing evaluation.