Abstract
BackgroundThe purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography.MethodsDescriptive design with follow-up was used in the study. Data from breast cancer screening and health insurance claim data were used. The study population consisted of all participants in breast cancer screening from 2009 to 2014. Crude detection rate, positive predictive value and sensitivity and specificity of breast cancer screening and, incidence rate of interval cancer of the breast were calculated.ResultsThe crude detection rate of breast cancer screening per 100,000 participants increased from 126.3 in 2009 to 182.1 in 2014. The positive predictive value of breast cancer screening per 100,000 positives increased from 741.2 in 2009 to 1,367.9 in 2014. The incidence rate of interval cancer of the breast per 100,000 negatives increased from 51.7 in 2009 to 76.3 in 2014. The sensitivities of screening for breast cancer were 74.6% in 2009 and 75.1% in 2014 and the specificities were 83.1% in 2009 and 85.7% in 2014.ConclusionsTo increase the detection rate of breast cancer by breast cancer screening using mammography, the participation rate should be higher and an environment where accurate mammography and reading can be performed and reinforcement of quality control are required. To reduce the incidence rate of interval cancer of the breast, it will be necessary to educate women after their 20s to perform self-examination of the breast once a month regardless of participation in screening for breast cancer.
Highlights
The purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography
For early detection of breast cancer, the National Health Insurance Service (NHIS) in Korea began screening for breast cancer using mammography and physical examination of the breast concurrently once every 2 years without copayment in 1999, targeting women with medical aid who were over 40 years of age [2]
The committee that developed the Korean guideline for breast cancer screening concluded that the benefits of screening for breast cancer with mammography outweighed the potential harm based on the results of meta-analysis using the domestic and foreign literature on death rate, total death rate, and stage shift of breast cancer and they issued the Korean guidelines for breast cancer screening, encouraging women ages 40–69 to undergo breast cancer screening by mammography and physical examination every 2 years [4]
Summary
The purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography. For early detection of breast cancer, the National Health Insurance Service (NHIS) in Korea began screening for breast cancer using mammography and physical examination of the breast concurrently once every 2 years without copayment in 1999, targeting women with medical aid who were over 40 years of age [2]. The committee that developed the Korean guideline for breast cancer screening concluded that the benefits of screening for breast cancer with mammography outweighed the potential harm based on the results of meta-analysis using the domestic and foreign literature on death rate, total death rate, and stage shift of breast cancer and they issued the Korean guidelines for breast cancer screening, encouraging women ages 40–69 to undergo breast cancer screening by mammography and physical examination every 2 years [4]. Mammography is the best radiological diagnostic screening tool from the cost–effectiveness viewpoint, and many countries and institutes encourage breast cancer screening using this method [13]
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