Abstract
Process indices are important for the quality control of breast cancer screening. The Cancer Control Act introduced in 2006 clearly demanded an improvement in the quality of cancer screening, and each prefectural government requested a report about indices of the cancer screening process from the institutions concerned. The outcome of cancer screening efficacy is a decrease in the cancer death rate. The annual quality of cancer screening activity is indicated by process indices, including the participation rate, recall rate, cancer detection rate, positive predictive value, the rate of early cancer detection, and the proportion of responders for recall examination. The structure of cancer screening includes such as the type of screening examination, the target population and the way of screening. Therefore, cancer screening activity is evaluated in term of three aspects: structure, process and outcome (so-called Donabedian method). In order to aggregate these process indices exactly, there is a need to exchange information about responders between other institutions. Currently there are limitation on the extent to which personal information can be exchanged, but this must be overcome in the benefit of public health. Tochigi Public Health Service Association has been performing an independent combined breast cancer screening program since 2000, entrusted by cities in Tochigi prefecture. Although the recall rate of independent combined screening has tended to be high. The recall rate of ultrasonographic screening will be more decreased by reference with previous images or by use of blood flow images, elastography and movie images. In addition, in the combination-type screening to improve the mechanism of comprehensive judgment by knowing the characteristics of each modality by a detailed study of process indices, which is expected to increase the screening accuracy.
