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J Healthc Qual Res. 2019 Jul - Aug;34(4):177-184. doi: 10.1016/j.jhqr.2019.02.007. Epub 2019 Jun 28.

Dissemination of health technologies: Trends in the use of diagnostic test in breast cancer screening.

Author information

1
Hospital Universitario Central de Asturias, Principality of Asturias Health Service, Spain. Electronic address: carmen.natal@sespa.es.
2
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), University of Oviedo, Spain.
3
Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute) and Research Network on Health Services in Chronic Diseases (REDISSEC), Spain.
4
Cancer Prevention and Monitoring Programme, Catalan Institute of Oncology, Spain.
5
Department of Preventive Medicine and Public Health, University of Oviedo, Asturias, Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain.
6
IMIM (Hospital del Mar Medical Research Institute), Barcelona.
7
Corporacio Sanitaria Parc Taulı, Sabadell.
8
Catalan Institute of Oncology, Barcelona.
9
Hospital de la Santa Creu i Sant Pau, Barcelona.
10
General Directorate of Public Health, Department of Health, Government of Cantabria.
11
Principality of Asturias Health Service.
12
University of Oviedo, Oviedo. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid.
13
Institut d'Investigacions Sanitàries Pere Virgili, Reus.
14
Hospital Santa Caterina, Girona.
15
Catalan Cancer Plan, Catalan Health Government, Barcelona, Spanish Cancer Research Network (RTICC), Carlos III Health.

Abstract

OBJECTIVE:

To analyse trends in the use of diagnostic test in breast cancer screening programs in Spain.

MATERIALS AND METHODS:

Retrospective study of 542,695 women who had undergone at least one screening mammogram in any of the screening centres of three administrative regions in Spain, between 1996 and 2011. Process measures were: overall recall rate, overall invasive test rate, and rates of each type of invasive test (fine-needle aspiration biopsy, core-needle biopsy and surgical biopsy). As results measures were included detection of benign lesions rate, ductal in situ cancer rate and invasive cancer rate. Adjusted by age rates were estimated year by year for each measure and, also, the annual percent of change and its corresponding joint points.

RESULTS:

Core-needle biopsy rates decreased between 1996 and 1999 and changed trends in 1999-2011 with an increase of 4.9% per year. Overall recall rate declined by 4.6% from 1999 to 2004, invasive test rate declined between 1996 and 2004 by 24.3%. Fine-needle aspiration biopsy rate changes were: a 22.4% declined per year (1996-1998), and 13.5% declined per year (1998-2005). Benign lesions rate decreased from 1996 to 2011, 21.4% per year (1996-2001) and 6.0% (2001-2011). Ductal carcinoma in situ and invasive cancer had no-statistically significant changes.

CONCLUSION:

The introduction of core-needle biopsy was slow and not concurrent with the reduction in the use of other diagnostic tests, but also represented a reduction in the rate of overall diagnostic tests and in the detection rate of benigns lesions without affecting the cancer detection rates.

KEYWORDS:

Biopsia con aguja gruesa; Breast cancer; Cancer screening; Cribado de cáncer de mama; Cáncer de mama; Diffusion of innovation; Difusión de la innovación; Evaluación de servicios sanitarios; Health services research; Health technology; Large-core needle biopsy; Tecnologías sanitarias

PMID:
31713528
DOI:
10.1016/j.jhqr.2019.02.007

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