Population-based breast cancer screening in Pavia (northern Italy) in 2016-2018: Key performance indicators and sensitivity estimate

Population-based breast cancer screening in Pavia (northern Italy) in 2016-2018: Key performance indicators and sensitivity estimate

Authors

  • Silvia Deandrea Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Federica Manzoni Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Marina Tanious Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
  • Andrea Parrini Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Marinella Crema Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Pietro Perotti Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Simona Dalle Carbonare Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Giancarlo Magenes Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Ennio Cadum Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Lorenza Boschetti Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Stefano Marguati Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Lorella Cecconami Health Protection Agency (ATS) of Pavia, Pavia, Italy
  • Anna Odone Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy

Keywords:

breast cancer, mammography screening, interval cancers, sensitivity, proportional incidence

Abstract

Background and aim: This study aims to assess the quality of the population-based breast cancer screening programme in Pavia, northern Italy computing its key performance indicators and estimating its sensitivity for the years 2016-2018.

Methods: Invitation and examination coverage, participation rate, recall rate, detection rate and positive predictive values were computed on the basis of data provided yearly to the Italian Ministry of Health. Sensitivity was estimated identifying interval cancers in the local Cancer Registry and computed with the proportional incidence method.

Results: In 2016-2018 the adjusted invitation coverage was 90%, and the adjusted participation rate was 62%. Recall rate was 8.4% for first screenings and 3.9% for subsequent ones. The number of screen-detected cases was 268, corresponding to a detection rate of 6.6‰ for first screenings and 4.6‰ for subsequent screenings. The number of interval cancers observed was 110 over the study period; the proportional incidence was 22% for the first interval year and 50% for the second interval. The overall sensitivity of the screening program was 64%.

Conclusions: The analysis of performance indicators and sensitivity estimates for the Pavia programme indicates that the programme performance is in line with the quality standards set by the European Union and the Italian reference scientific society (GISMa).

References

AIOM. I numeri del cancro in Italia 2022. 2022 Dec. [Internet] Available from: https://www.aiom.it/wp-content

/uploads/2022/12/2022_AIOM_NDC-web.pdf

Zorzi M, Guzzinati S, Puliti D, Paci E. A simple method to estimate the episode and programme sensitivity of breast cancer screening pro-grammes. Journal of Medical Screening. 2010;17(3):132-138. doi:10.1258/jms.2010.009060

Giudici F, Bortul M, Clagnan E, et al. Effetti precoci dell’adesione al programma di screening mammografico della Regione Friuli Venezia Giulia sull’incidenza del cancro della mammella in stadio avanzato: uno studio di coorte [Early effects of attendance to the Friuli Venezia Giulia (Northern Italy) mammography screening programme on the incidence of advanced-stage breast cancer: a cohort study]. Epidemiol Prev. 2020 Mar-Jun;44(2-3):145-153. [Italian]. doi: 10.19191/EP20.2-3.P145.037.

Bennett RL, Sellars SJ, Moss SM. Interval cancers in the NHS breast cancer screening programme in England, Wales and Northern Ire-land. Br J Cancer. 2011 Feb 15;104(4):571- 7. doi: 10.1038/bjc.2011.3.

Coppola L, Schivardi MR, Deandrea S. Analisi e monitoraggio dei cancri di intervallo nei programmi di screening oncologici organizzati. In-dirizzi metodologici. 2020, Jun. [Italian].

Ciatto S, Naldoni C, Ponti A, et al.; Gruppo di Studio Italiano per lo Screening Mammografico. I carcinomi di intervallo quali indicatori di performance di un programma di screening [Interval cancers as indicators of performance in screening programmes]. Epidemiol Prev. 2008 Mar-Apr;32(2):93-8. [Italian].

Battisti F, Mantellini P, Falini P, et al. Key performance indicators of breast cancer screening programmes in Italy, 2011-2019. Ann Ist Su-per Sanita. 2022 Oct-Dec;58(4):244-253. doi: 10.4415/ANN_22_04_04.

Giordano L, Giorgi D, Frigerio A, et al.; Gruppo Italiano per lo Screening Mammografico. Indicatori e standard per la valutazione di proces-so dei programmi di screening del cancro della mammella [Process indicators and standards for the evaluation of breast cancer screening programmes]. Epidemiol Prev. 2006 Mar-Apr;30(2 Suppl 1):5-9, 11-47. [Italian].

European Commission. European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis. 4th edition. In Perry N., Broeders M., de Wolf C. i wsp. (red.): Office for Official Publications of the European Communities, Luxembourg 2006.

Bucchi L, Ravaioli A, Foca F, Colamartini A, Falcini F, Naldoni C. Incidence of interval breast cancers after 650,000 negative mam-mographics in 13 Italian health districts. Journal of Medical Screening. 2008;15(1):30-35. doi:10.1258

/jms.2008.007016

Burani R, Caimi F, Maggioni C, et al. Quality assessment of the mammographic screening programme in the Azienda Sanitaria locale Pro-vincia Milano 1 -- analysis of interval cancers and discussion of possible causes of diagnostic error. Radiol Med. 2005 Mar;109(3):260-7. [English, Italian].

Taylor R, Supramaniam R, Rickard M, Estoesta J, Moreira C. Interval breast cancers in New South Wales, Australia, and comparisons with trials and other mammographic screening programmes. Journal of Medical Screening. 2002;9(1):20-25. doi:10.1136/jms.9.1.20

Taylor R, Page A, Bampton D, Estoesta J, Rickard M. Age-specific interval breast cancers in New South Wales and meta-analysis of stud-ies of women aged 40-49 years. J Med Screen. 2004;11(4):199-206. doi: 10.1258/0969141042467403.

Törnberg S, Kemetli L, Ascunce N, et al. A pooled analysis of interval cancer rates in six European countries. Eur J Cancer Prev. 2010 Mar;19(2):87-93. doi: 10.1097

/CEJ.0b013e32833548ed.

Chubak J, Burnett-Hartman AN, Barlow WE, et al. Estimating Cancer Screening Sensitivity and Specificity Using Healthcare Utilization Data: Defining the Accuracy Assessment Interval. Cancer Epidemiol Biomarkers Prev. 2022;31:1517-20. doi: 10.1158/1055-9965.EPI-22-0232.

Muratov S, Canelo-Aybar C, Tarride JE, et al. Monitoring and evaluation of breast cancer screening programmes: selecting candidate performance indicators. BMC Cancer. 2020;20:795. doi: 10.1186/s12885-020-07289-z

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Published

30-08-2023

How to Cite

1.
Deandrea S, Manzoni F, Tanious M, Parrini A, Crema M, Perotti P, et al. Population-based breast cancer screening in Pavia (northern Italy) in 2016-2018: Key performance indicators and sensitivity estimate . Acta Biomed [Internet]. 2023 Aug. 30 [cited 2024 Oct. 7];94(S3):e2023160. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/14511