Mass screening program for breast cancer in Somme district. Sir year results (1990-1996)

Background: Randomized clinical trials have demonstrated that screening by mammography can reduce breast cancer mortality by 30% in women. aged 50 to 69 years. In France, pilot screening programs were begun in 1989 and partic ularly in the Somme district. After 6 years and two rounds, the aim of this study was to assess the quality and the effectiveness of this screening pr ogram. Methods: The quality of the campaign was measured concerning effectiveness (recall rate, positive predictive value of screening lest or of the screeni ng procedure, intervention rate, breast cancer detection rate) or quality ( percentage of in situ cancers, invasive cancers smaller than 10 mm, invasiv e cancers without lymph node invasion). These indicators were compared with European targets. Results: Attendance rates at 6 years ranged from 33.6% to 37.1%. The recall rate was 14.3% in the first and 7.8% in the second round 6.4 and 6 cancers were detected per 1 000 women screened during the first and second round, and 38.5% of invasive cancers were of 10 mm or less (27.4% during the first round) and 70.8% had no nodal involvement (68.3% during the first round). Conclusion: Results from the screening system are variable yet satisfactory overall, due to the progressive implementation of quality assurance. Howev er attendance rates remain low, whereas actual coverage is 64% in Somme dis trict.