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Performance of Screening Mammography: A Report of the Alliance for Breast Cancer Screening in Korea

  • Lee, Eun Hye (Department of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Keum Won (Department of Radiology, Konyang University Hospital, Konyang University College of Medicine) ;
  • Kim, Young Joong (Department of Radiology, Konyang University Hospital, Konyang University College of Medicine) ;
  • Shin, Dong-Rock (Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Park, Young Mi (Department of Radiology, Busan Paik Hospital, Inje University College of Medicine) ;
  • Lim, Hyo Soon (Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine) ;
  • Park, Jeong Seon (Department of Radiology, Hanyang University Hospital, Hanyang University College of Medicine) ;
  • Kim, Hye-Won (Department of Radiology, Wonkwang University Hospital, Wonkwang University School of Medicine) ;
  • Kim, You Me (Department of Radiology, Dankook University Hospital, Dankook University College of Medicine) ;
  • Kim, Hye Jung (Department of Radiology, Kyungpook National University Hospital, Kyungpook National University College of Medicine) ;
  • Jun, Jae Kwan (National Cancer Control Institute, National Cancer Center)
  • Received : 2015.11.08
  • Accepted : 2016.03.15
  • Published : 2016.07.01

Abstract

Objective: To analyze the diagnostic accuracy and trend in screening mammography in Korea. Materials and Methods: We retrospectively linked the information from hospitals participating in the Alliance of Breast Cancer Screening in Korea (ABCS-K) and the database of the National Cancer Screening Program. We calculated performance indicators, including the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false-positive rate (FPR), and interval cancer rate (ICR). Changes in the performance indicators were calculated as the annual percent change with 95% confidence interval (CI). Results: We enrolled 128756 cases from 10 hospitals from 2005 to 2010. The recall rate was 19.1% with a downward trend over time (-12.1% per year; 95% CI, -15.9 to -8.2). The CDR was 2.69 per 1000 examinations, without a significant trend. The PPV was 1.4% with an upward trend (20.8% per year; 95% CI, 15.2 to 26.7). The sensitivity was 86.5% without a significant trend, whereas the specificity was 81.1% with an upward trend (3.3% per year; 95% CI, 2.1 to 4.5). The FPR was 18.9% with a downward trend (-12.4% per year; 95% CI, -16.2 to -8.4). The ICR was 0.5 per 1000 negative examinations without a significant trend. There were institutional variations in the diagnostic accuracy and trend except for the CDR, sensitivity, and ICR. Conclusion: The sensitivity and CDR of screening mammography in the ABCS-K from 2005 to 2010 were compatible with those for Western women. The recall rate, PPV and specificity, however, were suboptimal, although they showed significant improvements over this period. A further analysis is required to explain institutional variations.

Keywords

Acknowledgement

Supported by : Ministry of Health & Welfare

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