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© 1996 Oxford University Press

research-article

Sojourn Time, Sensitivity and Positive Predictive Value of Mammography Screening for Breast Cancer in Women Aged 40–49

S W DUFFY*, H H CHEN*, LASZLO TABAR**, GUNNAR FAGERBERG{dagger} and EUGENIO PACI{ddagger}

*MRC Biostatistics Unit, Institute of Public Health, University Forvie Site Robinson Way, Cambridge, CB2 2SR, UK
**Mammography Department, Central Hospital 79182 Falun, Sweden
{dagger}Department of Radiology, University Hospital Linkoping, Sweden
{ddagger}CSPO, Epidemiology Unit Via San Salvi 12, 50131 Florence, Italy

Duffy S W (MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK), Chen H H, Tabar L, Fagerberg G and Paci E. Sojourn time, sensitivity and positive predictive value of mammography screening for breast cancer in women aged 40–49. International Journal of Epidemiology 1996; 25: 1139–1145.

BACKGROUND: In mammographic screening for breast cancer in women aged 40–49, previous studies have found very low estimates of sensitivity and predictive value. Methods of estimation have, however, used primitive models with relatively strong assumptions and less than full use of the data.

METHODS: Here we estimate the underlying preclinical incidence, mean sojoum time, sensitivity and positive predictive value by a variety of methods in a randomized trial of mammographic screening (The Swedish Two-County Trial) and a service screening programme (The Florence Programme, 1975–1986) in women aged 40–49 years.

RESULTS: In the Two-County study, sensitivity estimates ranged from 72–83% and predictive value from 39–89%. In the Florence programme, sensitivity estimates ranged from 69–85% and predictive value was uniformly estimated as 100%.

CONCLUSIONS: The methods involving more explicit modelling of the disease process and fewer assumptions tended to find higher estimates of predictive value in the Two-County study. The results suggest that previously poor sensitivity and predictive value estimates may have been overpessimistic.

Keywords breast cancer screening, sojourn time, sensitivity, positive predictive value

Revised 1 April 1996


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