programas cribado cancer

Nota bibliográfica cribado c mama 2013-12

Rauscher GH, Murphy AM, Orsi JM, Dupuy DM, Grabler PM, Weldon CB. Beyond the Mammography Quality Standards Act: Measuring the Quality of Breast Cancer Screening Programs. Am J Roentgenol. 2013;202(1):145–51. Available from: doi: 10.2214/AJR.13.10806.

CONCLUSION. The results suggest a combination of quality of care issues and incomplete tracking of patients. To accurately measure the quality of the breast cancer screening process, it is critical that there be complete tracking of patients with abnormal screening mammography findings so that results can be interpreted solely in terms of quality of care. The MQSA guidelines for tracking outcomes and measuring quality indicators should be strengthened for better assessment of quality of care.

Hale PJ, DeValpine MG. Screening Mammography: Revisiting Assumptions About Early Detection. J Nurse Pract. 2013; Available from:

Recommendations for the frequency of mammography screening vary across several professional advisory groups. In 2009, the United States Preventive Services Task Force Guidelines reduced screening to biennially for women 50-74 years old. Drivers of this change were false-positive results and unnecessary biopsies, exposure to radiation, and treatment of cancers that would never develop. Despite the recommendation, surveys show that screening has actually increased since the change. A review of the individual woman’s risk and a more balanced approach addressing both the benefits and harms of screening is required so that patients can make an informed choice.

Séradour B, Heid P, Estève J. Comparison of Direct Digital Mammography, Computed Radiography, and Film-Screen in the French National Breast Cancer Screening Program. Am J Roentgenol. 2013;202(1):229–36. Available from: doi: 10.2214/AJR.12.10419.

CONCLUSION. Direct digital mammography has a higher detection rate than film-screen mammography in dense breasts and for tumors of high grade. This latter association warrants further study to measure the impact of technology on efficacy of screening. The data indicate that computed radiography detects fewer tumors than film-screen mammography in most instances.

Lee CH. Radiologic Screening for Breast Cancer: Current Controversies. Curr Radiol Rep. 2013;2(2):34. Available from: doi: 10.1007/s40134-013-0034-8.

 Abstract Breast cancer is the most commonly occurring cancer, aside from skin cancer, among American women and the second leading cause of cancer death. Screening with mammography has been used for decades in this country, and since its introduction, there has been a reduction in breast cancer mortality. However, controversy surrounding the use of mammography to screen for breast cancer continues. In addition, the development of newer imaging techniques that can be applied to breast cancer screening has generated further debate about the value and appropriate use of radiologic imaging for breast cancer screening.

Strech D. Participation rate or informed choice? Rethinking the European key performance indicators for mammography screening. Health Policy (New York). (0). Available from: doi:

 Abstract Despite the intensive controversies about the likelihood of benefits and harms of mammography screening almost all experts conclude that the choice to screen or not to screen needs to be made by the individual patient who is adequately informed. However, the “European guideline for quality assurance in breast cancer screening and diagnosis” specifies a participation rate of 70% as the key performance indicator for mammography screening. This paper argues that neither the existing evidence on benefits and harms, nor survey research with women, nor compliance rates in clinical trials, nor cost-effectiveness ratios justify participation rates as a reasonable performance indicator for preference-sensitive condition such as mammography screening. In contrast, an informed choice rate would be more reasonable. Further research needs to address the practical challenges in assessing informed choice rates.

Eklund M, Esserman LJ. Screening: Biology dictates the fate of young women with breast cancer. Nat Rev Clin Oncol. 2013;10(12):673–5. Available from:

Kerrison R, Shukla H, Cunningham D, Oyebode O, Friedman E. Are text message reminders an effective intervention to improve uptake of breast
screening? A randomised controlled trial
. Lancet. 2013;382:S9. Available from: doi: 10.1016/S0140-6736(13)62434-4.

 Interpretation Receipt of a text message reminder 48 h before a scheduled breast screening appointment signifi cantly improves uptake. To ensure that the benefi ts of text message reminders are achieved, work is needed to improve patient mobile records.
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