Déterminants liés aux variations de la sensibilité, de la spécificité et du rapport de vraisemblance positif du dépistage par mammographie dans le cadre du Programme québécois de dépistage du cancer du sein

Authors: Tchuente, Vanina
Advisor: Diorio, CarolineThéberge, Isabelle
Abstract: In the Quebec Breast Cancer Screening Program (Programme québécois de dépistage du cancer du sein, PQDCS), women, radiologists and facilities characteristics may influence the screening performance. This study aim to identify those characteristics associated with sensitivity, specificity and accuracy (positive likelihood ratio) of screening mammography. This study consists of 3,727,724 mammograms performed on women aged between 50 and 69 in the PQDCS between January 2002 and September 2015. Data on the characteristics were obtained through three databases: the PQDCS information system, RAMQ and MedEcho. The associations of women, radiologists and facilities characteristics to sensitivity, specificity and accuracy was assessed by multivariable Poisson regression with robust error variance. Among the mammograms included, 368,079 were considered as abnormal and 17,867 lead to a diagnosis of invasive cancers (15,412 screen-detected cancers and 2,455 interval cancers). Overall, the sensitivity is 86.3 %, the specificity is 90.5 % and the accuracy is 9.1. Some characteristics are associated with an increase of the screening performance including woman’s age, being post-menopausal and having a high annual volume of mammograms for radiologists. Others are associated with a decrease of the performance, including having a history of breast puncture or biopsy, having an initial mammogram, having a high body mass index, taking a hormone replacement therapy, having a high breast density, being a female radiologist, using a digital mammogram in a screening facility. As the evaluation of the performance of the PQDCS is important, it is relevant to know the characteristics associated with it, in order to understand better the mechanisms by which the program could be improved.
Document Type: Mémoire de maîtrise
Issue Date: 2019
Open Access Date: 9 February 2019
Permalink: http://hdl.handle.net/20.500.11794/33514
Grantor: Université Laval
Collection:Thèses et mémoires

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