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Korean J Radiol. 2017 Jul-Aug;18(4):624-631. doi: 10.3348/kjr.2017.18.4.624. Epub 2017 May 19.

Analysis of Participant Factors That Affect the Diagnostic Performance of Screening Mammography: A Report of the Alliance for Breast Cancer Screening in Korea.

Author information

1
Department of Radiology, Konyang University Hospital, Konyang University College of Medicine, Daejeon 35365, Korea.
2
Department of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon 14584, Korea.
3
National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea.
4
Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Korea.
5
Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 47392, Korea.
6
Department of Radiology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan 54538, Korea.
7
Department of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan 31116, Korea.
8
Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Hwasun 58128, Korea.
9
Department of Radiology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea.
10
Department of Radiology, Kyungpook National University Medical Center, Kyungpook National University College of Medicine, Daegu 41404, Korea.

Abstract

OBJECTIVE:

To analyze participant factors that affect the diagnostic performance of screening mammography.

MATERIALS AND METHODS:

We enrolled 128756 cases from 10 hospitals between 2005 and 2010. We analyzed recall rate, cancer detection rate (CDR) per 1000 examinations, positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and interval cancer rate (ICR) per 1000 negative examinations according to participant factors including age, breast density, and number of visit to the same institution, and adjusted for confounding variables.

RESULTS:

Increasing age improved recall rates (27.4% in 40's, 17.5% in 50's, 11.1% in 60's, and 8.6% in 70's), CDR (2.7, 3.2, 2.0, and 2.4), PPV (1.0, 1.8, 1.8, and 2.8%), sensitivity (81.3, 88.8, 90.3, and 94.7%), specificity (72.7, 82.7, 89.0, and 91.7%), and FPR (27.3, 17.3, 11.0, and 8.4%) (p < 0.05). Higher breast density impaired recall rates (4.0% in P1, 9.0% in P2, 28.9% in P3, and 27.8% in P4), PPV (3.3, 2.3, 1.2, and 1.3%), specificity (96.1, 91.2, 71.4, and 72.5%), and FPR (3.9, 8.9, 28.6, and 27.6%) (p < 0.001). It also increased CDR (1.3, 2.1, 3.3, and 3.6) and ICR (0.2, 0.3, 0.6, and 1.6) (p < 0.05). Successive visits to the same institution improved recall rates (20.9% for one visit, 10.7% for two visits, 7.7% for more than three visits), PPV (1.6, 2.8, and 2.7%), specificity (79.4, 89.6, and 92.5%), and FPR (20.6, 10.4, and 7.5%) (p < 0.001).

CONCLUSION:

Young age and dense breasts negatively affected diagnostic performance in mammography screening, whereas successive visits to the same institution had a positive effect. Examinee education for successive visits to the same institution would improve the diagnostic performance.

KEYWORDS:

Audit; Cancer detection rates; National mammography database; Screening mammography

PMID:
28670157
PMCID:
PMC5447638
DOI:
10.3348/kjr.2017.18.4.624
[Indexed for MEDLINE]
Free PMC Article

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