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Evolution of breast cancer screening in countries with intermediate and increasing incidence of breast cancer.
- Source :
- Journal of Medical Screening; Dec2006 Suppl., Vol. 13 Issue 4, p23-27, 5p, 4 Charts, 1 Graph
- Publication Year :
- 2006
-
Abstract
- Background: Few studies have been published regarding the practice of breast cancer screening in Asian countries. Aims: The present study illustrates how the health policy for breast cancer screening has evolved in Taiwan from selective mammographic screening within a high-risk group, firstly to a programme of physical examination by public health nurses, and finally to a two-stage breast cancer screening programme, with a risk assessment followed by mammography for those at moderate to high risk. Data sources: Breast cancer screening has evolved from 1995 to 2004 in Taiwan in three stages: (1) selective screening for breast cancer with mammography, ultrasound and physical examination only in first-degree relatives of breast cancer cases (1995–1998); (2) a programme of mass screening (1999–2001) with physical examination by public health nurses; and (3) two-stage breast cancer screening with a risk factor questionnaire and mammography for those deemed at moderate-to-high risk (2002–2004). The questionnaire was based on significant risk factors in a previous epidemiological study, in conjunction with the physical examination programme, a risk score was constructed from the logistic regression coefficients from the previous study, and women with a score above the median in the previous epidemiological study were assigned to mammography. Results: Two-stage mammography screening had the most favourable results compared with the two previous screening regimes. It had a positive predictive value of recall after mammography of 14%, compared with 8% for selective screening and 2% for physical examination. Of screen-detected cancers in the two-stage programme, 71% were either ductal carcinoma in situ or stage T1, compared with 61% for selective screening and 60% for physical examination. The area under the receiver operating characteristic curve was 71% for the two-stage programme. Conclusions: For a low- to medium-risk country such as Taiwan, two-stage screening has acceptable parameters of recall and cancer detection, and compares well with other screening strategies. [ABSTRACT FROM AUTHOR]
- Subjects :
- BREAST cancer
MAMMOGRAMS
BREAST cancer risk factors
MEDICAL screening
Subjects
Details
- Language :
- English
- ISSN :
- 09691413
- Volume :
- 13
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Journal of Medical Screening
- Publication Type :
- Academic Journal
- Accession number :
- 23562077