Double versus single reading of mammograms in a breast cancer screening programme: a cost-consequence analysis

Margarita C. Posso, Teresa Puig, Ma Jesus Quintana, Judit Solà-Roca, Xavier Bonfill

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)

Abstract

© 2016, European Society of Radiology. Objectives: To assess the costs and health-related outcomes of double versus single reading of digital mammograms in a breast cancer screening programme. Methods: Based on data from 57,157 digital screening mammograms from women aged 50–69 years, we compared costs, false-positive results, positive predictive value and cancer detection rate using four reading strategies: double reading with and without consensus and arbitration, and single reading with first reader only and second reader only. Four highly trained radiologists read the mammograms. Results: Double reading with consensus and arbitration was 15 % (Euro 334,341) more expensive than single reading with first reader only. False-positive results were more frequent at double reading with consensus and arbitration than at single reading with first reader only (4.5 % and 4.2 %, respectively; p < 0.001). The positive predictive value (9.3 % and 9.1 %; p = 0.812) and cancer detection rate were similar for both reading strategies (4.6 and 4.2 per 1000 screens; p = 0.283). Conclusions: Our results suggest that changing to single reading of mammograms could produce savings in breast cancer screening. Single reading could reduce the frequency of false-positive results without changing the cancer detection rate. These results are not conclusive and cannot be generalized to other contexts with less trained radiologists. Key Points: • Double reading of digital mammograms is more expensive than single reading. • Compared to single reading, double reading yields a higher proportion of false-positive results. • The cancer detection rate was similar for double and single readings. • Single reading may be a cost-effective strategy in breast cancer screening programmes.
Original languageEnglish
Pages (from-to)3262-3271
JournalEuropean Radiology
Volume26
Issue number9
DOIs
Publication statusPublished - 1 Sep 2016

Keywords

  • Breast neoplasms
  • Costs and cost analysis
  • Early detection of cancer
  • Mammography
  • Mass screening

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