Estimation of years of life gained within the pilot screening program of the Ariana area of Tunisia

: Breast cancer is the principle cancer among female cancer in Tunisia. It represents 30% of the woman's cancers with about 1000 new cases per year. The main intervention control is mass screening using mammography in to reduce breast cancer mortality. Breast cancer screening efficacy in term of breast cancer mortality reduction is closely related to incidence and survival of this cancer. National Office of Family and Population (ONFP) conducted a pilot experience of breast cancer mass screening using the mammography in place. The main objective of this study is to calculate the potential number of life years saved through this pilot experience of the ONFP. For the methodology, we used the software Dismod (Disease Model) for the evaluation of the prevalence and the duration of the cancer of the breast in the governorate, as well as to estimate the number of life years saved. The potential breast cancer mortality reduction is 30% for women aged of 50 at 69 years, and 10% for those aged of 40 at 49 years. Breast cancer incidence in Ariana according to age for the period 1995-1998, has been calculated from the data base of cancer registry of the North of Tunisia. According to Dismod, mean duration in the absence of screening, is 11.12 years for the age group 40 to 49 years and 9.57 for the age group 50 at 69 years. Screening would increase these duration means of 2.22 years and 1.71 years, respectively for age groups 40 to 49 years and 50 at 69 years. The number of life years saved for 1000 women is of 2.97 years. In conclusion breast cancer screening using mammography would be actually little benefit in Tunisia. Mammography should be reserved for the diagnosis of the suspected cases and screening for high risk women.