[The effectiveness of breast cancer screening in our country]

Utilization of screening mammography as a preventive practice prior to initiating a population-based breast cancer screening program

Factors associated with the level of utilization of screening mammography as a preventive practice were analyzed prior to initiating a population-based breast cancer screening program. A questionnaire was used to collect information about screening mammography utilization during the last 4 years among women invited to enroll in the program. Sociodemographic and health factors, and health services utilization were studied. A screening mammography in the last 4 years had been performed on 59.3% of the 8867 women interviewed. The utilization of mammography was higher among women who were younger, had a higher education level, or had previous visits to a physician (P < 0.001). The variables more strongly associated with use of screening mammography were: visit to a gynecologist and performance of a pap smear. Also associated with the utilization of screening mammography were: personal history of breast pathology, family history of breast cancer, breast self-examination, and recent visit to a general practitioner. Self-perceived health presented an inverse relation with screening mammography use (P < 0.001). The use of screening mammography appears to have increased in recent years, although inequalities persist which the breast cancer screening programs help to modulate. Mammographic frequency only would be deemed appropriate by the European guidelines in fewer than one-half of the cases.

Evaluation of the regular practice of breast cancer screening in a health area

Breast cancer screening has proved to be efficacious only in clinical trials or structured programs. However, little is known of its effectiveness as a regular practice. This study is an assessment of breast cancer screening in regular practice in a Spanish area of 350,000 inhabitants through analysis of existing sources of information. It is evident that this screening is insufficient, inefficient, very variable, nonspecific, and probably ineffective, although there is insufficient information to prove it. The immediate implementation of a well-structured and accredited screening program is essential to overcome the current limitations.

[Survival of women with breast cancer in a hospital-based registry (1979-1991)]

We analyzed the survival of 268 women diagnosed with breast cancer between 1979 and 1991, registered at the Tumour Registry of the Hospital S. Jaume i Sta. Magdalena, Mataró (Barcelona). Relative survival rates at two, five and ten years were 0.84, 0.69 and 0.49, respectively. The largest difference in survival was observed in relation to the stage at the time of diagnosis. The survival was worse in women aged between 30 and 39 years and between 80 and 89 years. No significant differences were observed in survival in relation to the interval from first symptoms to diagnosis. The survival at 5 years shows some trend towards improvement during the period between 1979 and 1986.