Arzel, Béatrice

Bulliard, Jean-Luc

De Landtsheer, Jean-Pierre

Fioretta, Gérald

Jemelin, Claude

Levi, Fabio

Serveur académique lausannois

Evaluation of the Swiss mammography screening programmes and comparative performance of organised vs opportunistic screening

 Environnement Humain/EHU-5   EVALUATION OF THE SWISS MAMMOGRAPHY SCREENING PROGRAMMES AND COMPARATIVE PERFORMANCE OF ORGANISED VS OPPORTUNISTIC SCREENING   1Bulliard J.-L., 2de Landstheer J.-P., 3Jemelin C., 4Arzel B., 5Fioretta G., 6Levi F.    Cancer Epidemiology Unit, University Institute of Social and Preventive Medicine (IUMSP), Lausanne1, Breast Cancer Screening Foundation (formerly), Lausanne2, Breast Cancer Screening Program of Valais, Sion3, Breast Cancer Screening Foundation, Geneva4, Geneva Cancer Registry, Geneva5, Vaud Cancer Registry, Lausanne6    BACKGROUND:   Swiss health insurance regulation has limited the reimbursement of organised screening mammography to a period of 10 years, ending in December 2007.  Continued reimbursement of this screening test within a programme necessitated the most comprehensive analysis of breast cancer screening ever performed in Switzerland.  OBJECTIVES:   To extensively evaluate all Swiss regional screening programmes and to compare prognostic indicators between screened and unscreened women, both within and outside regions covered by a programme.  METHODS: Performance of regional programmes were assessed according to European Guidelines. Detection and screening modalities (organised vs opportunistic screening, no screening, interval cancers) were obtained by data matching with population-based Swiss cancer registries. Analyses focussed on the 3 oldest programmes (Geneva, Vaud and Wallis) which, although very similar in their organization, had different reading strategies.  RESULTS: Screening performances met most European standards and a substantial breast cancer stage shifting was observed. Most of the variations in performances across programmes could be ascribed to reading strategies. Opportunistic and organised screening yielded little difference in prognostic profile in regions which offered organised screening. Breast cancer prognostic indicators were systematically more favourable in Swiss regions covered by a programme. In regions without a screening programme, the higher the prevalence of opportunistic screening, the better the prognostic profile.   CONCLUSION: Mammography screening has influenced the stage distribution of breast cancer in Switzerland, and a favourable impact on mortality is anticipated. Organised screening was as effective as opportunistic screening, a finding that to date only few studies have been able to explore. Extension of organised mammography screening to the whole of Switzerland is warranted.      Table des matières     Message du Vice-Doyen de la  Recherche de a Faculté de Biologie et de Médecine    Programme      Abstracts  EHU  Environnement Humain  4 ENA  Environnement Naturel  27 GEN  Gènes et Environnement 31 IMI  Immunité et Infection 59 MCV  Métabolisme et Cardiovasculaire 97 NEU Neurosciences et Psyché 139 ODE  Oncologie et Développement 165 THE  Procédures Thérapeutiques 197   Index des auteurs  215    Couverture : Yannick Krempp, Département de Biologie Cellulaire et de Morphologie – UNIL   Photo : DNA microarray image of an RNA expression profiling experiment provided by  Manuela Weier and Henrik Kaessmann of the Centre Intégratif de Génomique - CIG and Jérôme Thomas of the Lausanne DNA Array Facility, Centre Intégratif de Génomique - CIG            Comité scientifique Jacques Beckmann, Service de Génétique médicale - CHUV Gé V  Poster Jury Karine Baumer, Institut de Pathologie – CHUV Di V Administration de la Recherche Jovan Mirkovitch, Faculté de Biologie et de Médecine – CHUV / UNIL Co      Comité d’organisation 2009    Nouria Hernandez, Centre intégratif de génomique - UNIL Ivan Stamenkovic, Institut de Pathologie – CHUV Amalio Telenti, Institut de Microbiologie – CHUV rard Waeber, Service de Médecine interne - CHU mitri Favre, Service de Médecine interne – CHUMarie-Aude Le Bitoux, Institut de Pathologie – CHUV Erwann Vieu, Centre intégratif de génomique – UNIL     Anne Tricot, Faculté de Biologie et de Médecine - UNIL raline Fraga, Faculté de Biologie et de Médecine - CHUV 

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Evaluation of the Swiss mammography screening programmes and comparative performance of organised vs opportunistic screening

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