The introduction of a breast cancer screening programme in a region with a population at medium risk for developing breast cancer: Khanty-Mansiysky autonomous Okrug-Ugra (Russian Federation).

BACKGROUND

A breast cancer screening programme (BCSP) was started in 21 districts in the Khanty-Mansiysky Autonomous Okrug-Ugra region from 7 February 2007.

METHODS

From the data on the numbers of subjects screened and the resulting diagnoses we calculated screening coverage rates and cancer detection rates and estimated the sensitivity of the screening tests. The State Cancer Registry was the source for the data regarding the female population by age, the number of breast cancer cases and cancer-related deaths. The data pertained to the period 2002-9, and included pathology data. Disease rates and distribution graphs of tumours by size and node status were analysed using Poisson regression.

RESULTS

The rates of breast cancer incidence and mortality indicate that the region is one in which the population is at medium risk of developing the disease. There was a significant increase in incidence overall during the period studied (p = 0.03), and a significant downward trend in breast-cancer-related mortality to a greater extent in the 50+ age group (p = 0.004), and when all ages 40+ were considered (p < 0.001). During 2007-9 92,576 women were screened in the BCSP. The screening coverage rate was ∼30%. Of the women who were screened, 9% were referred for further assessment. The average cancer detection rate was 2.5 per 1000 women screened. The sensitivity of the test was estimated to be 74%. Approximately 90% of screening-detected cases of breast cancer were at stages 1 or 2 of the disease.

CONCLUSION

The finding that screening led to tumours being detected at earlier stages of the disease suggests that, in the long term, the programme will be successful in achieving a further reduction in mortality from the disease.