The effect of screening programmes on the treatment of benign breast neoplasms: observations from current practice in Italy

Abstract

Purpose: In the Lazio region, Italy, mammographic screening programmes were gradually activated from 1999 to 2003, providing an opportunity to compare two unselected populations in the same time period: women who were contacted in writing, and those who had not been contacted. In this study, we compare the incidences of treatments for benign and malignant neoplasms in the two groups. Methods: The target population was women aged 50–69 years. We linked all incident cases of surgery for benign and malignant breast neoplasms, from the Hospital Information System (1999–2003) to the Mammographic Screening Information System (1999–2001). We calculated incidence, adjusted for age and standardized breast cancer mortality ratio in each area of residence, for benign and malignant neoplasms surgery in non-yet-contacted and contacted woman. Incidence for contacted women was calculated for the two years following initial contact. Results: The target population in Lazio is 681,000; 116,000 women were contacted during the study period and 3252 malignant and 1566 benign neoplasms were surgically treated. Annual incidence was, respectively, 2.0/1000 and 1.1/1000 for malignant and benign neoplasms in women not contacted, and, respectively, 2.9/1000 and 1.1/1000 in the contacted population. Among the contacted group, annual incidence was 4.3/1000 and 1.5/1000 in compliant women, and 2.0/1000 and 0.9/1000 in non-compliant women. About one-half of the surgeries for benign neoplasms in compliant women were treated against the recommendation of the screening programme. Conclusions: The implementation of the screening programme did not increase the incidence of treatment for benign neoplasms, and detected 50% more malignant neoplasms.