A single issue program in an isolated area: mammography screening in Darwin, NT

Objective: A process evaluation of the Northern Territory (NT) mammography program, NT Breast Screen (NTBS), during its initial 18 months of operation . Methods: The study was undertaken in Darwin, NT, from December 1994 to May 1996. Clinical outcomes were obtained by reviewing computerised and manual program records to determine waiting times for results, recall rates and ca ncer detection rates. Client satisfaction was assessed by a questionnaire s ent to all women with normal results over a 12-week period. General practit ioner satisfaction was assessed by a questionnaire sent to all general prac titioners in the region who had one or more clients who had attended the se rvice. Results: During this time, 2,882 screening mammograms were performed; 98 wo men were recalled for assessment (3.4%). Breast cancer was detected in 10 w omen (3.5 per 1000 women screened). The program was well accepted by client s and general practitioners. Performance criteria were not met for waiting times for results. Conclusions: NTBS faced challenges because of its smalt and dispersed popul ation, a lack of local radiologists with mammographic experience and the co nflict with other pressing health issues, particularly in Aboriginal health . Despite those challenges, the program functioned effectively during its i nitial 18 months. Implications: Mammography screening programs in isolated areas can function effectively. The constraints encountered by NTBS are likely to apply to si milar programs. Issues identified requiring further research are the psycho logical consequences of long waiting times for results, and the prioritisat ion of mammography for Aboriginal women.