[Variations in the diagnostic confirmation process between breast cancer mass screening units]. / Variaciones en el proceso de confirmación diagnóstica entre unidades de cribado poblacional de cáncer de mama.
Gac Sanit
; 30(4): 265-71, 2016.
Article
en Es
| MEDLINE
| ID: mdl-27137776
OBJECTIVE: To analyse variations in the diagnostic confirmation process between screening units, variations in the outcome of each episode and the relationship between the use of the different diagnostic confirmation tests and the lesion detection rate. METHOD: Observational study of variability of the standardised use of diagnostic and lesion detection tests in 34 breast cancer mass screening units participating in early-detection programmes in three Spanish regions from 2002-2011. RESULTS: The diagnostic test variation ratio in percentiles 25-75 ranged from 1.68 (further appointments) to 3.39 (fine-needle aspiration). The variation ratio in detection rates of benign lesions, ductal carcinoma in situ and invasive cancer were 2.79, 1.99 and 1.36, respectively. A positive relationship between rates of testing and detection rates was found with fine-needle aspiration-benign lesions (R(2): 0.53), fine-needle aspiration-invasive carcinoma (R(2): 0 28), core biopsy-benign lesions (R(2): 0.64), core biopsy-ductal carcinoma in situ (R(2): 0.61) and core biopsy-invasive carcinoma (R(2): 0.48). CONCLUSIONS: Variation in the use of invasive tests between the breast cancer screening units participating in early-detection programmes was found to be significantly higher than variations in lesion detection. Units which conducted more fine-needle aspiration tests had higher benign lesion detection rates, while units that conducted more core biopsies detected more benign lesions and cancer.
Palabras clave
Análisis de áreas pequeñas; Assessment of health services; Breast cancer; Clinical practice variation; Cáncer de mama; Detección precoz de cáncer; Diagnostic techniques and procedures; Early detection of cancer; Evaluación de servicios sanitarios; Small area variation analysis; Técnicas y procedimientos diagnósticos; Variaciones en la práctica médica
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias de la Mama
/
Carcinoma in Situ
/
Tamizaje Masivo
/
Carcinoma Ductal de Mama
/
Biopsia con Aguja Fina
/
Biopsia con Aguja Gruesa
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Screening_studies
Límite:
Female
/
Humans
Idioma:
Es
Revista:
Gac Sanit
Asunto de la revista:
SAUDE PUBLICA
Año:
2016
Tipo del documento:
Article
Pais de publicación:
España