TY - JOUR
T1 - Interval cancers as related to frequency of recall to assessment in the South Australian population-based breast screening program
T2 - An exploratory study
AU - Boyle, Terry
AU - Reintals, Michelle
AU - Holmes, Andy
AU - Buckley, Elizabeth
AU - Roder, David
PY - 2022/8
Y1 - 2022/8
N2 - 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.
AB - 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.
KW - Australia
KW - Interval cancer
KW - Mammography screening
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=85134071500&partnerID=8YFLogxK
U2 - 10.1016/j.canep.2022.102183
DO - 10.1016/j.canep.2022.102183
M3 - Article
C2 - 35609348
AN - SCOPUS:85134071500
SN - 1877-7821
VL - 79
JO - Cancer Epidemiology
JF - Cancer Epidemiology
M1 - 102183
ER -