RESULTS AND EVALUATION OF 3 YEARS OF LARGE SCALE MAMMOGRAPHY PROGRAM IN THE ARIANA STATE IN TUNISIA

##plugins.themes.academic_pro.article.sidebar##

Download
pdf
Vol. 87 No. 7 (2009): Issue Jul 2009

##plugins.themes.academic_pro.article.main##

Bouchlaka A
Division Recherche Biomédicale Office National de la Famille et de la Population (ONFP) Tunis Tunisie
Ben Abdallah M
Service d'Epidémiologie Biostatistique et Informatique Médicale Institut Salah Azaiz Tunis Tunisie
Ben Aissa R
Division Recherche Biomédicale Office National de la Famille et de la Population (ONFP) Tunis Tunisie
Zaanouni E
Division Recherche Biomédicale Office National de la Famille et de la Population (ONFP) Tunis Tunisie Unité de dépistage du cancer du sein par mammographie
Kribi L
Division Recherche Biomédicale, Office National de la Famille et de la Population (ONFP), Tunis, Tunisie;Service de radiologie, hôpital Charles Nicolle - Tunis,unité de mammographie de l'office national de la famille et de la population
Smida S
Division Recherche Biomédicale Office National de la Famille et de la Population (ONFP) Tunis Tunisie
M'barek F
Division Recherche Biomédicale Office National de la Famille et de la Population (ONFP) Tunis Tunisie
Ben Hamida A
Service de la Médecine Préventive Faculté de médecine Tunis Tunisie
Boussen H
Service d'oncologie médicale Institut Salah Azaiz Tunis TunisieService de la Médecine Préventive
Gueddana N
Division Recherche Biomédicale Office National de la Famille et de la Population (ONFP) Tunis Tunisie

Abstract

Objective : To asses and analyse the results of 3 years large scale mammography screening of breast cancer in Ariana state in Tunisia
Materials and methods : This program, managed by the Family and Population National Office, was addressing to women aged from 49 to 69 years old residing in a area with adds up a population of 459 700 inhabitants including 52 729 women in the target age population. The screening was including a breast clinical examination and a mammography with two incidences face and external profile. The women was invited at their residence or were sensitized in the reproductive health centers, care and base health centers or by a close relation which heard of the program. An enlightened assent was submitted to the women who wished to profit from the screening.
Results : In three years, 9093 mammography were carried out of which 8244 were retained in the analyses, that is to say a rate participation of 9,6%. The rate of women recalled for suspect test was of 18,1% and it was of 13,1% among women of more than 50 years. The rate of practiced surgical biopsies was of 0,5% and the positive predictive value was of 45,5%. The average time between the date of screening and the result of the screening was 9,7 days, more important in the event of tests requiring a complementary assessment (61,7 days). On the whole 40 cancers were detected by the program, that is to say a rough rate of detected cancers, of 4,9 ‰, in conformity with the recommendations. The percentage of invasive cancers ² 10 mm was of 24,3 whereas percentages of in situ cancers
and of cancers without ganglionic invasion were respectively of 7,7% and of 50,0%.
Conclusions : The weakness of our study lay primarily in the rate of participation which remained weak. The methodology adopted for the sensitizing of the women is proven not very effective and did not allow inviting all eligible women. Results of the study are encouraging in spite of its limited impact and made it possible to
detect an important rate of cancers of which cancers infra-private clinics.

Keywords:

Screening, mammography, breast cancer, evaluation, results, Tusnisia

##plugins.themes.academic_pro.article.details##

References

  1. Registre Nord Tunisie données 1995-1998. Publication 200 Institut Salah Azaiez. Institut de la Santé Publique.
  2. Maalej M, Hentati D, Messai T, Kochbati L, El May A, Mrad K, Romdhane KB, Ben Abdallah M, Zouari B. Breast cancer in Tunisia in 2004: a comparative clinical and epidemiological study. Bull cancer. 2008 ;95 :E5-9
  3. American College of Radiology. Breast Imaging Reporting and Data System (BI-RADS). 3d. Ed. Reston, Va ; American College of Radiology, April 1998.
  4. Europe Against Cancer. European Guidelines for Quality Assurance in Mammography Screening. European Commission. Third ed., 2001
  5. Demissie K, Mills OF, Rhoads GG. Empirical comparison of the results of randomized controlled trails and case control studies in evaluating the effectiveness of screening mammography. J Clin Epidemiol 1998 ; 51 :81-91
  6. Hackshaw A. EUSOMA review of mammography screening Ann Oncol. 2003 ;14 :1193-5
  7. Freedman DA, Petitti DB, Robins JM. On the efficacy of screening for breast cancer. Int J Epidemiol. 2004 ;33 :43-55
  8. Paty A.-C., Dr.Ancelle-Park R., Dr. Bloch J.. Dépistage du cancer du sein. Rapport d'évaluation du suivi épidémiologique. Données 2004. http://www.invs.sante.fr/publications/2007/cancer_sein/index.html
  9. Smith-Bindman R, Ballard-Barbash R, Miglioretti DL, Patnick J, Kerlikowske K. Comparing the performance of mammography screening in the USA and the UK. J Med Screen. 2005;12:50-4
  10. Otten JD, Karssemeijer N, Hendriks JH, Groenewoud JH, Fracheboud J, Verbeek AL, de Koning HJ, Holland R. Effect of recall rate on earlier screen detection of breast cancers based on the Dutch performance indicators. J Natl Cancer Inst. 2005 18;97:748-54
  11. Harvey SC, Geller B, Oppenheimer RG, Pinet M, Riddell L, Garra B. Increase in cancer detection and recall rates with independent double interpretation of screening mammography. AJR Am J Roentgenol. 2003 ;180 :1461-7