Interval cancers as related to frequency of recall to assessment in the South Australian population-based breast screening program: An exploratory study |
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| Affiliation: | 1. Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia;2. BreastScreen South Australia, Adelaide, South Australia, Australia;1. Department of Surgery and Endoscopy, Tenwek Hospital, Bomet, Kenya;2. Department of Surgery, Alpert Medical School of Brown University, Providence, RI, USA;3. Biostatistics Branch, Division of Cancer and Epidemiology, National Cancer Institute, Rockville, MD, USA;4. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA;5. Department of Pathology, University of Nairobi, Nairobi, Kenya;6. Mayo Clinic, Rochester, MN, USA;1. Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Germany;2. School of Public Health, Department of Epidemiology, Boston University, Boston, USA;3. Cancer Registry of North Rhine-Westphalia, Bochum, Germany;4. Saarland Cancer Registry, Saarbrücken, Germany;5. CaritasKlinikum Saarbrücken St. Theresia, Saarbrücken, Germany;1. Faculty of Medicine, University of Iceland, Reykjavik, Iceland;2. Department of Pathology, Landspitali University Hospital of Iceland, Reykjavik, Iceland;3. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Landspitali University Hospital of Iceland, Reykjavik, Iceland;1. Cancer Control Office, King Hussein Cancer Center, Amman 11941, Jordan;2. Section of Pulmonary and Critical Care, Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan;3. Pharmacy Student, University of Jordan, Amman 11972, Jordan;4. Volunteer Research Program at King Hussein Cancer Center, Amman 11941, Jordan;5. Medical Student, University of Jordan, Amman 11972, Jordan;1. Section of Hematology-Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA;2. Texas Children’s Cancer and Hematology Centers, Texas Children’s Hospital, Houston, TX, USA;3. Center for Epidemiology and Population Health, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA;4. Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA |
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| Abstract: | Australian accreditation standards specify upper limits for percentages of women recalled for further assessment following screening mammography. These limits have been unchanged since national screening commenced circa 1990, although screening target ages have changed, and technology from analogue to digital mammography. This study compared 2804 women with interval cancers diagnosed since national screening began (cases) with 14,020 cancer-free controls (5 controls per case), randomly selected after matching by age, round, screen type and calendar year of screening episode, to determine the odds of interval cancer by differences in clinic recall to assessment percentages. Within low numbers of recalls that were within accepted accreditation ranges, results did not indicate more frequent recalls to assessment to be associated with fewer interval cancers in the analogue era. However, more frequent recalls were associated with reduced interval cancers for digital screens. These results are not conclusive, requiring confirmation in other screening environments, especially those with larger numbers of digital screens. If confirmed, frequency of recalls to assessment may need adjustment to get the best trade-offs in the digital era between reduced odds of interval cancers from more recalls and increases in financial and non-financial costs, including increased potential for overdiagnosis. |
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| Keywords: | Australia Screening Mammography screening Interval cancer |
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