CMAJ • January 18, 2005; 172 (2). doi:10.1503/cmaj.1040485.
© 2005 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Théberge, I.
Right arrow Articles by Brisson, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Théberge, I.
Right arrow Articles by Brisson, J.
Related Collections
Right arrow Radiological diagnosis
Right arrow Breast Cancer
Right arrowRelated Article

Research
Recherche

Volume of screening mammography and performance in the Quebec population-based Breast Cancer Screening Program

Isabelle Théberge, Nicole Hébert-Croteau, André Langlois, Diane Major and Jacques Brisson

From Direction des systèmes de soins et services, Institut national de santé publique du Québec, Sainte-Foy, Que. (all authors), Centre de recherche, Hôpital Charles LeMoyne, Greenfield Park, Que. (Hébert-Croteau), and Unité de recherche en santé des populations, Hôpital du Saint-Sacrement du Centre hospitalier affilié universitaire de Québec, Québec, Que. (Brisson)

Background: In the Quebec Breast Cancer Screening Program (Programme québécois de dépistage du cancer du sein [PQDCS]), radiologists' and facilities' volumes of screening mammography vary considerably. We examined the relation of screening-mammography volume to rates of breast cancer detection and false-positive readings in the PQDCS.

Methods: The study population included 307 314 asymptomatic women aged 50–69 years screened during 1998–2000. Breast cancer detection rates were analyzed by comparing all women with screening-detected breast cancer (n = 1709) and a 10% random sample of those without (n = 30 560). False-positive rates were analyzed by comparing the 3159 women with false-positive readings and the 27 401 others in the 10% random sample. Characteristics of participants, radiologists and facilities were obtained from the PQDCS information system. Data were analyzed by means of logistic regression.

Results: The rate of breast cancer detection appeared to be unrelated to the radiologist's screening-mammography volume but increased with the facility's screening-mammography volume. The breast cancer detection rate ratio for facilities performing 4000 or more screenings per year, compared with those performing fewer than 2000, was 1.28 (95% confidence interval [CI] 1.07–1.52). In contrast, the frequency of false-positive readings was unrelated to the facility's screening volume but was inversely related to the radiologist's screening volume: the rate ratio for readers of 1500 or more screenings per year compared with those reading fewer than 250 was 0.53 (95% CI 0.35–0.79).

Interpretation: Radiologists' and facilities' caseloads showed independent and complementary associations with performance of screening mammography in the PQDCS. Radiologists who worked in larger facilities and read more screening mammograms had higher breast cancer detection rates while maintaining lower false-positive rates.


Related Article

Breast cancer screening, diagnostic accuracy and health care policies
Jean-Luc Urbain
Can. Med. Assoc. J. 2005 172: 210-211. [Full Text] [PDF]



This article has been cited by other articles:


Home page
 Ann OncolHome page
C. Hery, J. Ferlay, M. Boniol, and P. Autier
Quantification of changes in breast cancer incidence and mortality since 1990 in 35 countries with Caucasian-majority populations
Ann. Onc., June 1, 2008; 19(6): 1187 - 1194.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
R. Smith-Bindman, D. L. Miglioretti, R. Rosenberg, R. J. Reid, S. H. Taplin, B. M. Geller, K. Kerlikowske, and the National Institutes of Health Breast Cancer Su
Physician Workload in Mammography
Am. J. Roentgenol., February 1, 2008; 190(2): 526 - 532.
[Abstract] [Full Text] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
D. L. Miglioretti, R. Smith-Bindman, L. Abraham, R. J. Brenner, P. A. Carney, E. J. A. Bowles, D. S. M. Buist, and J. G. Elmore
Radiologist Characteristics Associated With Interpretive Performance of Diagnostic Mammography
J Natl Cancer Inst, December 19, 2007; 99(24): 1854 - 1863.
[Abstract] [Full Text] [PDF]

Home page
 JNCI J Natl Cancer InstHome page
R. Smith-Bindman, P. Chu, D. L. Miglioretti, C. Quale, R. D. Rosenberg, G. Cutter, B. Geller, P. Bacchetti, E. A. Sickles, and K. Kerlikowske
Physician Predictors of Mammographic Accuracy
J Natl Cancer Inst, March 2, 2005; 97(5): 358 - 367.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
B. Kermode-Scott
Detection of breast cancer is better in centres performing a high volume of mammography
BMJ, January 29, 2005; 330(7485): 214.
[Full Text]

Home page
 CMAJHome page
J.-L. Urbain
Breast cancer screening, diagnostic accuracy and health care policies
Can. Med. Assoc. J., January 18, 2005; 172(2): 210 - 211.
[Full Text] [PDF]