Outcome of a quality-controlled Mammography screening program---an experience of a population-based study in Taiwan

Purpose

To report the clinical outcome of screening mammography in Taiwan.

Materials and Methods: A total of 2,473,608 consecutive screening mammographies were performed for women of ages 50-69 years (2004-2009) and 45-69 years thereafter with the screening coverage of 33.2% of the target population in the recent two years. The workload of every screening radiologist, the overall recall rate, PPV1, cancer detection rate, cancer incidence rate from the screening, one-year interval cancer, sensitivity and specificity of the screening mammography are calculated, which are also compared with the ACR recommendation level.

Results: The cancer detection rates and cancer incidence rates increase from 3.94-4.08 and 4.80-5.04 to 4.71-5.04 and 5.71 after 2009, implying high occurrence of the breast cancer in younger age group of 45-49 years. The recall rates (9.3-10.0%) in this review are within the ACR recommendation range (<10%) and the PPV1 has also reached the ACR recommended level (> 5%) in the recent two years. The sensitivity in our study is slightly lower than that of ACR recommended level (> 85%), which is still comparable to the result of Vermont area in USA. Although the workload (screenees/screeners) for every radiologist each year has increased from 150 in 2004 to 1360 in 2012, it seems not to worsen the outcome quality of this screening program.

Conclusion: From the outcome review of this mammography screening, we still have a room to ameliorate our performance through comprehensive and continue education to improve the competence of cancer detection and decrease false negative cases.