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. 2011 May 10:11:288.
doi: 10.1186/1471-2458-11-288.

Breast cancer screening in the Czech Republic: time trends in performance indicators during the first seven years of the organised programme

Ondrej Majek  1 , Jan Danes, Miroslava Skovajsova, Helena Bartonkova, Lucie Buresova, Daniel Klimes, Petr Brabec, Pavel Kozeny, Ladislav Dusek
Affiliations

Breast cancer screening in the Czech Republic: time trends in performance indicators during the first seven years of the organised programme

Ondrej Majek et al. BMC Public Health. .

Abstract

Background: The Czech Breast Cancer Screening Programme (CBCSP) was initiated in September 2002 by establishing a network of accredited centres. The aim of this article is to describe progress in the programme quality over time after the inception of the organised programme.

Methods: The CBCSP is monitored using an information system consisting of three principal components: 1) the national cancer registry, 2) a screening registry collecting data on all screening examinations, further assessments and final diagnoses at accredited programme centres, and 3) administrative databases of healthcare payers. Key performance indicators from the European Guidelines have been adopted for continuous monitoring.

Results: Breast cancer incidence in the Czech Republic has steadily been increasing, however with a growing proportion of less advanced stages. The mortality rate has recently stabilised. The screening registry includes 2,083,285 records on screening episodes between 2002 and 2008. In 2007-2008, 51% of eligible women aged 45-69 were screened. In 2008, the detection rates were 6.1 and 3.7 per 1,000 women in initial and subsequent screening respectively. Corresponding recall rates are 3.9% and 2.2%, however, it is necessary to pay attention to further assessment performed during the screening visits. Benign to malignant open biopsy ratio was 0.1. Of invasive cases detected in screening, 35.6% was less than 10 mm in diameter. Values of early performance indicators, as measured by both crude and standardized estimates, are generally improving and fulfil desirable targets set by European Guidelines.

Conclusions: Mammography screening in the Czech Republic underwent successful transformation from opportunistic prevention to an organised programme. Values of early indicators confirm continuous improvement in different aspects of process quality. Further stimulation of participation through invitation system is necessary to exploit the full potential of screening mammography at the population level.

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Figures

Figure 1
Figure 1
Structure of a patient record in the Czech Breast Cancer Screening Registry.
Figure 2
Figure 2
Time trends of breast cancer incidence and mortality rates in the Czech Republic. Source of data: Czech National Cancer Registry.
Figure 3
Figure 3
Time trends in age-specific breast cancer incidence rate. Source of data: Czech National Cancer Registry.
Figure 4
Figure 4
Comparison of age structure of breast cancer patients groups diagnosed in different time periods. Source of data: Czech National Cancer Registry.
Figure 5
Figure 5
Time trends in distribution of clinical stages in newly diagnosed breast cancer cases in the Czech Republic. Source of data: Czech National Cancer Registry.
Figure 6
Figure 6
Time trends of breast cancer incidence rates in women aged 45-69 years, according to clinical stage at diagnosis. Source of data: Czech National Cancer Registry.
Figure 7
Figure 7
Breast cancer detection rate: age-specific comparison of time periods.
Figure 8
Figure 8
Further assessment rate: age-specific comparison of time periods.
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