PT - JOURNAL ARTICLE AU - Dana Paquette AU - Judy Snider AU - Françoise Bouchard AU - Ivo Olivotto AU - Heather Bryant AU - Kathleen Decker AU - Gregory Doyle AU - for the Database Management Subcommittee for The Canadian Breast Cancer Screening Initiative TI - Performance of screening mammography in organized programs in Canada in 1996 DP - 2000 Oct 31 TA - Canadian Medical Association Journal PG - 1133--1138 VI - 163 IP - 9 4099 - http://www.cmaj.ca/content/163/9/1133.short 4100 - http://www.cmaj.ca/content/163/9/1133.full SO - CMAJ2000 Oct 31; 163 AB - Background: The results of randomized trials show that breast cancer screening by mammography reduces breast cancer mortality by up to 40% in women aged 50-69 years. Because of these results, by 1998, 22 countries, including Canada, had established population-based organized screening programs. This paper presents the results of screening mammography in 1996 for 7 provincially organized breast cancer screening programs in Canada. Methods: Analyses of interim performance indicators for screening mammography have been calculated from data submitted to the Canadian Breast Cancer Screening database. The data set consisted of data from 7 provincial programs and was limited to mammographic screens for women aged 50-69 years (n = 203 303). Screening outcomes and performance indicators were calculated for abnormalities detected by screening mammography only. Results: The abnormal recall rate was 9.5% for first screens and 4.6% for subsequent screens, and the cancer detection rate per 1000 women screened was 6.9 for first screens and 3.8 for subsequent screens. The positive predictive value (i.e., the proportion of women who tested positive by mammography who were found to have breast cancer on screen-initiated diagnostic work-up) increased from 7.2% at the first screen to 8.2% at subsequent screens. Estimated participation rates within organized programs varied from 10.6% to 54.2%, depending on the province. Interpretation: For 1996, organized breast cancer screening programs met or exceeded many of the interim measures used in international programs. It is possible to translate the benefits of breast cancer screening by mammography, as demonstrated in randomized trials, into population-based community programs. Screening mammography through organized programs should increase to allow more comprehensive monitoring in Canada.