1451P - Five-year results of the breast cancer screening programme in Ugra

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Breast Cancer
Cancer Aetiology, Epidemiology, Prevention
Presenter Natalia Zakharova
Authors N.A. Zakharova1, S.W. Duffy2, J. Mackay3, E.V. Kotlyarov4, A.V. Filimonov5, K. Barinov1, I. Gromut1, E.V. Belan1
  • 1Oncological, State Oncology Center, 628012 - Khanty-Mansiysk/RU
  • 2Wolfson Institute Of Preventive Medicine, Queen Mary University of London, London/UK
  • 3Consultant Clinical Genetic Oncologist, University College London, London/UK
  • 4Oncology, State Medical Academy, 628012 - Khanty-Mansiysk/RU
  • 5Chief, State Healthcare Department, 628012 - Khanty-Mansiysk/RU

Abstract

The main purpose of this study is to estimate the five-year result of the Breast Cancer Screening Program (BCSP) performed in the Khanty-Mansiysk Autonomous Okrug - Ugra. This Programme was initiated in 2007. The screening covers women over 40 years old. The screening interval is 2 years, with two-view mammography (MLO and CC) and single reading as the standard. During 2007–2011 within the BCSP, 201668 women were screened (177475 - prevalence screening). The screening coverage rate is approximately 56.4%. In 2011 we also evaluated the efficacy of usage for the mammography equipment in each district. According to the standard (RF) – there are 2840 examinations per day (2381 examinations per day - the average number in Ugra). Thus, the coverage rate only for the districts with the sufficient number of the examinations per day estimated as 68.4%. 10.3% of screened women were referred for further assessment. There were 460 breast cancer cases detected at the first round of screening and 22 cases in subsequent rounds. The cancer detection rate for prevalence was 2.6 and for subsequent rounds 0.9 per 1000 screened women. The test sensitivity for the first round was estimated as 77%. Also, we have tentatively evaluated the likely future effect on mortality from the breast cancer as a result of the BCSP in Ugra, on the basis of the changes in mortality seen at this early stage of the programme and of the changes in size and node status of the cancers diagnosed. In 2009–11, a reduction in breast cancer mortality of the order of 15–20% was observed, compared to previous years. We anticipate a 20% reduction in deaths from breast cancer by 2015, on the basis of this and of reductions in the proportion of tumours of size >20 mm. The changes in the tumour size distribution do not appear to be due to length bias or overdiagnosis, since the overall incidence is consistent with pre-screening trends of increasing incidence. Analysis of node status is complicated by possible changes in practice with respect to axillary investigation. We are planning to increase the proportion of the digital mammography equipment in order to improve the quality of the examination and then - to implement the CAD (computer-aided detection) system. Thus, in the future in Ugra, it is planned to continue the BCSP, and to continue to improve the quality of screening.

Disclosure

All authors have declared no conflicts of interest.