BREAST-CANCER SCREENING - CHARACTERISTICS AND RESULTS OF THE ITALIAN PROGRAMS IN THE ITALIAN GROUP FOR PLANNING AND EVALUATING BREAST-CANCER SCREENING PROGRAMS (GISMA)

In 1990, GISMa (Italian Group for planning and evaluating Mammographic Screening - Gruppo Italiano per la pianificazione e la valutazione de i programmi di Screening Mammografico), a working group of operators ( radiographers, radiologists, epidemiologists, clinicians, surgeons) in volved in screening programmes ongoing in Italy, was created within th e Italian School of Senology. The aim of this study is to illustrate d ata, presented at the GISMa meeting held in April 1994, concerning the characteristics of each programme and some early indicators of effect iveness. To assess these parameters (concerning compliance level, reca ll rate, benign/malignant biopsy ratio, detection rate, stage distribu tion, nodal involvement and number of cancers with a diameter under 1 cm, rate of cancer, etc.), 'acceptable' and 'desirable' standards obta ined from Italian and North-European cancer screening experiences have been adopted. Most programmes have shown an acceptable standard for m ost of the indicators, and many of them have attained desirable levels . In most screening programmes the occurrence of interval cancers has not yet been measured, but all centres have (or are working to set up) a systematic active procedure to collect the data. The results indica te that common guidelines can be adopted, even when working in very he terogeneous contexts, and that it is possible to achieve a very high e ffectiveness and efficacy level. As regards quality control and cost/b enefit issues, the goal of extending centralised, population-based scr eening programmes to other Italian regions becomes a priority.