Association between Screening Mammography Recall Rate and Interval Cancers in the UK Breast Cancer Service Screening Program: A Cohort Study

作者：Burnside Elizabeth S^*; Vulkan Daniel; Blanks Roger G; Duffy Stephen W

来源：Radiology, 2018, 288(1): 47-54.

DOI：10.1148/radiol.2018171539

Purpose: To determine whether low levels of recall lead to increased interval cancers and the magnitude of this effect.
Materials and Methods: The authors retrospectively analyzed prospectively collected data from the UK National Health Service Breast Screening Programme during a 36-month period (April 1, 2005 to March 31, 2008), with 3-year follow-up in women aged 50-70 years. Data on recall, cancers detected at screening, and interval cancers were available for each of the 84 breast screening units and for each year (n= 252). The association between interval cancers and recalls was modeled by using Poisson regression on aggregated data and according to age (5-year intervals) and screening type (prevalent vs incident).
Results: The authors analyzed 5 126 689 screening episodes, demonstrating an average recall to assessment rate (RAR) of 4.56% (range, 1.64%-8.42%; standard deviation, 1.15%), cancer detection rate of 8.1 per 1000 women screened, and interval cancer rate (ICR) of 3.1 per 1000 women screened. Overall, a significant negative association was found between RAR and ICR (Poisson regression coefficient: 20.039 [95% confidence interval: 20.062, 20.017]; P=.001), with approximately one fewer interval cancer for every additional 80-84 recalls. Subgroup analysis revealed similar negative correlations in women aged 50-54 years (P=.002), 60-64 years (P=.01), and 65-69 years (P=.008) as well as in incident screens (P=.001) and prevalent screens (P=.04). No significant relationship was found in women aged 55-59 years (P=.46).
Conclusion: There was a statistically significant negative correlation between RAR and ICR, which suggests the merit of a minimum threshold for RAR.

• 出版日期2018-7