OP0008 Insights from the national breast cancer screening programme of 1 million Chinese women

Abstract

<h3>Background</h3> Breast cancer patients in China present with more advanced tumour stages at diagnosis than do those in western countries. A government-organised Chinese national breast cancer screening programme (CNBCSP) was conducted by the Chinese Ministry of Health in the years 2008 and 2009. We assessed whether the implementation of a clinical breast examination (CBE)-based screening programme could downstage breast cancer in limited-resource populations. <h3>Methods</h3> A pilot study was done with 34,964 women to test the screening accuracy of CBE, mammography (MAM), and breast ultrasound (BUS) as screening tools and laid down the management standards for screening performance. The sensitivity and specificity of CBE, BUS, and MAM were 43.1% and 99.4%, 62.7% and 98.6%, and 85.7% and 98.1%, respectively. In the CNBCSP, all women first underwent CBE, followed by MAM or BUS. <h3>Findings</h3> Data from 398,387 women who took part in CNBCSP showed that the cancer detection rate was 0.56 per 1000 women in first-round screening, and 0.24 per 1000 women in second-round screening 1year later. Clinical stages I and II accounted for 73.0% and 80.0% of screening-detected cancers in the first and second round of the CNBCSP, which was 5.1% and 12.1% higher than clinic-detected cancers. <h3>Interpretation</h3> The findings indicate that the screening strategy used in CNBCSP can increase the detection rate of early-stage breast cancer in Chinese women. Policy makers should consider putting more efforts on quality control as well as increasing effectiveness when conducting mass screening in middle-income and low-income communities.