A pooled analysis of interval cancer rates in six European countries

The objective of this study was to assess detection rates and interval breast cancer (IC) rates from eight programmes in the European Breast Cancer Screening Network. A common data collection protocol was used to explore differences in IC rates among programmes and discuss their potential determinants. Pooled analysis was used to describe IC rates by age, compliance in screening, recall rate, screening detection (SD) rate and expected breast cancer incidence. Participation in screening averaged 77.9% (range 42.6–88.7%), recall rate 5.4% (range 3.3–17.7%) in the initial and 3.4% (range 1.8–8.9%) in the subsequent screening rounds, and SD rate was 60.4 (range 41.6–91) per 10 000 women in initial and 38.5 (range 31.3–62.6) in subsequent screens. IC rate during first 12 months after screening was 5.9 (range 2.1–7.3) per 10 000 women screened negative and 12.6 (range 6.3–15) in the second year of the interval. IC comprised 28% of the IC and SD cancers. The ratio between IC rate and expected incidence was 0.29 for the first 12 months and 0.63 for the 13–24 months period. Sensitivity was higher for the ages 60–69 years and for initial tests than subsequent tests. There were distinct differences in the IC rates between programmes. The results of this study reveal large variations in screening sensitivity and performance. Pooled evaluation of some process indicators within the European breast cancer screening programmes proved to be feasible and is likely to be useful for the future, particularly if it is performed regularly and extensively.