Scheduling mammography screening for the early detection of breast cancer in Korean women

Abstract

OBJECTIVE: To propose an efficient screening schedule for breast cancer among Korean women using the stochastic model in which the age-specific incidence rate was considered. SETTING: Female breast cancer data in the Korea Central Cancer Registry 2002. METHODS: The stochastic model was based on the threshold method, in which the schedule is determined by a pre-specified threshold value. The threshold value was defined as the probability of being in a preclinical state of breast cancer at age 40 years. The sensitivity of the mammography was specified as 0.7. Two models for mean sojourn time (MST) in the preclinical state were considered; MSTs for Model I were 2 (ages < 50 years), 3 (ages 50-59 years), and 4 years (ages > or = 60 years), and MSTs for Model II were 3, 4, and 5 years for the corresponding age groups. RESULTS: The threshold method for Model I generated 19 examinations within the screening ages of 40-69 years. Each screening time was determined at ages 40.0, 41.6, 43.2, 44.8, 46.0, 47.2, 48.4, 49.6, 50.7, 51.7, 52.7, 53.7, 54.7, 56.2, 57.8, 59.4, 61.3, 63.1, and 64.9 years. The schedule sensitivity of Model I was 64.2%, which was higher than that (57.5%) of the biennial periodic schedule. Model II included 11 screenings between the ages of 40 and 69 years and also showed a higher schedule sensitivity, especially for women aged 40 years as compared with the biennial screening. CONCLUSIONS: This finding suggests that the threshold screening schedule for breast cancer increase the schedule sensitivity by reflecting the age-specific incidence rate of a population.