PRACTICE OF LARGE SCALE MAMMOGRAPHY ARIANA IN STATE IN TUNISIA : PRECLUDING FOR AN ORGANIZED SCREENING ?
##plugins.themes.academic_pro.article.main##
Abstract
Objective : To study and analyse the results of breast cancer mammography screening program in the Ariana state and to try to determinate its feasibility and reproducibility on a broader scale.
Materials and methods : A pilot study on the mammography feasibility of screening with large scales was initiated, by Family and Population National Office, in September 2003. The duration of the study was fixed at 5 years. The adopted protocol takes account of epidemiologic and socialcultural specificities of Tunisian
environment that is in the selection and in the mode of recruitment of the target population as well as in the choice of the adopted radiological protocol.
Results : 8244 women were screened in the first round. The majority of sensitized women was recruited in residence and in the reproductive and health centers. Nevertheless, recruitment in residence was proved to be heavy, not very effective and no reproducible in a broader scale. The participation rate was weak
(9.6%). The channels of sensitizing used made it possible to touch in manner more important the “young” women (Middle Age 48.6 years). The absence of radiologist on the spot involved the recall of 18.1% of the women for which a complementary assessment was necessary, has to contribute to increase the stress among certain women and to increase the average time of reading which was, in this case, 61.7 days. The majority of the women profited from the double reading of the tests (99.4%). On the whole 50 women presented a cancer including 40 detected by the program and 10 interval cancers.
Conclusions : This study has permitted to study the feasibility of mammography study. Except the topic of the cost, the two hand conditions of his feasibility binds in the systematic invitation of the women as well as in the wider uses of sensitization and information ways of the population.
Keywords:
Screening, mammography, breast cancer, feasibility, protocol, Tunisia,##plugins.themes.academic_pro.article.details##
References
- Harris JR. Breast Cancer. N engl Med, 1992 ; 327 : 319-398
- Registre Nord Tunisie données 1995-1998. Publication 2000 Institut Salah Azaiz. Institut de la Santé Publique.
- American College of Radiology. Breast Imaging Reporting and Data System (BI-RADS). 3d. Ed. Reston, Va ; American College of Radiology, April 1998.
- Europe Against Cancer. European Guidelines for Quality Assurance in Mammography Screening. European Commission. Third ed., 2001
- M.C. Wagnon, H. Nagoda-Nicklewicz, A. Schartpantgen, R. Schaiden, C. Lux, F. Shannoun, Ch. Brochmann, M. Becker. Evaluation des cancers d'intervalle du programme mammographie au Grand-Duché de Luxembourg, période 1995- 1999 (résultats définitifs) et de janvier 2000 au 31 août 2002 (résultats préliminaires). J. Le Sein, 2003, 13, 169-177
- Yves Spyckerelle, Claude Kuntz, Jean-Pierre Giodanelle, Rosemary Ancelle-Park. Pratiques de la mammographie chez les femmes de 50 à 69 ans, comparaisons entre les départements avec et sans dépistage organisé. Bulletin Epidémiologique Hebdomadaire n°4/2003
- A. Vandenbroucke. Le dépistage : quelques modèles d'organisation en Belgique. J. Le Sein, 2003, 13, 75-79
- Smith RA. Breast cancer screening among women younger than age 50: a current assessment of the issues. CA Cancer J Clin ; 50:312-36
- Cahier des charges relatif à l'organisation du dépistage des cancers, aux structures de gestion, aux radiologues, annexés à la convention-type entre les organismes d'assurance maladie et les professionnels de santé. Bulletin officiel 2001-43 du 22 au 28 octobre 2001
- Ancelle-Park R., Nicolau J, Annie-Claude Paty. Programme de dépistage organisé du cancer du sein : tendances des indicateurs précoces. Bulletin Epidémiologique Hebdomadaire n°4/2003
- Ancelle-Park R., Institut de veille sanitaire. Implication du nouveau cahier des charges pour les indicateurs d'évaluation du dépistage organisé du cancer du sein. Bulletin Epidémiologique Hebdomadaire n°4/2003