Mammogrphic Screening Provided by the National Health Insurance Corporation: A 1 year Audit in a Secondary Medical Institution1

Purpose: We performed a medical audit of the mammograms performed as part of the existing public cancer screening program to propose a plan for improving the program. Materials and Methods: We analyzed the results of 3,317 mammograms performed between March 2006 and February 2007. The American College of Radiology Breast Imaging Reporting and Data System (ACRBI_RADS) guidelines were used for follow-up and outcome monitoring. Cases in categories 0, 4, and 5 were followed up by a review of the patient's medical records and a phone call survey to determine the reasons for not continuing with follow-up examinations. Results: The mean age of the women enrolled in this study was 51 years. The rate of recall was approximately 6.4% and the cancer detection rate was 2.1 out of every 1000 women examined. Positive predictive values (PPV) of 1, 2 and 3 were observed in 3.3%, 33.3% and 70.0%, respectively. The sensitivity and specificity were 100% and 93.8%, respectively. As a result of the phone-call survey to determine the reasons for not following up with additional examinations, 53.8% of cases were 'belittled since there was no subjective symptom,' and 16.3%, 'didn't check the cancer examination notice thoroughly or did not fully understand it'. Conclusion: The result of medical audit indicates that reading and follow-up examinations were conducted in a relatively proper manner. Taking into consideration the characteristics of the objects for public examination, it is thought that active follow-up management as well as a written notice of the results, is necessary for patients who were found to be abnormal.