Background
Methods
The Czech Breast Cancer Screening Programme
Czech National Cancer Registry
Claims data from healthcare payers
Data analysis
Results
Breast cancer burden in the Czech Republic
Results of the organised screening programme
Year (screening mammography) | |||||||
---|---|---|---|---|---|---|---|
2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | |
Number of women screened | 10,055 | 212,537 | 265,217 | 317,194 | 340,564 | 469,299 | 468,419 |
Estimate of 24 m coverage by examination
(women aged 45-69)
|
0.6%
|
13.1%
|
27.9%
|
33.8%
|
38.1%
|
44.8%
|
51.2%
|
Number of women with detected breast cancer | 48 | 1,053 | 1,250 | 1,445 | 1,570 | 2,542 | 2,128 |
Breast cancer detection rate
|
4.8
|
5.0
|
4.7
|
4.6
|
4.6
|
5.4
|
4.5
|
Standardized ratio (reference year 2008)
|
0.81
|
0.83
|
0.80
|
0.85
|
0.96
|
0.97
|
1.00
|
Number of women undergoing further assessment | 1,768 | 46,976 | 57,925 | 56,850 | 53,580 | 63,415 | 60,025 |
Further assessment rate
|
17.6%
|
22.1%
|
21.8%
|
17.9%
|
15.7%
|
13.5%
|
12.8%
|
Standardized ratio (reference year 2008)
|
0.90
|
1.20
|
1.21
|
1.14
|
1.10
|
1.01
|
1.00
|
Number of women recalled for further assessment | 557 | 12,095 | 11,725 | 11,931 | 10,429 | 13,977 | 12,955 |
Recall rate
|
5.5%
|
5.7%
|
4.4%
|
3.8%
|
3.1%
|
3.0%
|
2.8%
|
Women undergoing open biopsy - benign result | 21 | 504 | 347 | 285 | 194 | 249 | 173 |
Women undergoing open biopsy - malignant result | 43 | 867 | 1,021 | 1,259 | 1,347 | 2,149 | 1,794 |
Benign to malignant open biopsy ratio
|
0.49
|
0.58
|
0.34
|
0.23
|
0.14
|
0.12
|
0.10
|
Number of women with detected breast cancer (cases preceded by neoadjuvant therapy excluded)
| 48 | 1,031 | 1,212 | 1,400 | 1,522 | 2,470 | 2,039 |
Advanced cases (TNM II+) | 17 | 331 | 390 | 440 | 439 | 652 | 525 |
Advanced cases proportion
|
35.4%
|
32.1%
|
32.2%
|
31.4%
|
28.8%
|
26.4%
|
25.7%
|
Invasive cases | 41 | 933 | 1,097 | 1,283 | 1,370 | 2,211 | 1,831 |
Invasive cases proportion
|
85.4%
|
90.5%
|
90.5%
|
91.6%
|
90.0%
|
89.5%
|
89.8%
|
Node-negative invasive cases | 27 | 572 | 700 | 840 | 905 | 1,442 | 1,218 |
Proportion among invasive
|
65.9%
|
61.3%
|
63.8%
|
65.5%
|
66.1%
|
65.2%
|
66.5%
|
Invasive ≤ 10 mm cases | 11 | 312 | 360 | 460 | 504 | 770 | 651 |
Proportion among invasive
|
26.8%
|
33.4%
|
32.8%
|
35.9%
|
36.8%
|
34.8%
|
35.6%
|
Year screened | NUMBER OF WOMEN SCREENED | Proportion subsequent | AGE SCREENED | |||||
---|---|---|---|---|---|---|---|---|
Initial | Subsequent | 5th
percentile | 25th
percentile | Median | 75th
percentile | 95th
percentile | ||
2002
| 10,055 | 0 |
0.0%
| 45.6 | 49.2 |
53.8
| 59.0 | 66.5 |
2003
| 212,514 | 23 |
0.0%
| 45.7 | 49.4 |
53.9
| 59.3 | 66.7 |
2004
| 258,635 | 6,582 |
2.5%
| 45.4 | 49.4 |
54.2
| 59.7 | 66.9 |
2005
| 220,897 | 96,297 |
30.4%
| 45.5 | 50.0 |
54.9
| 60.3 | 67.1 |
2006
| 170,717 | 169,847 |
49.9%
| 45.5 | 50.1 |
55.1
| 60.5 | 67.2 |
2007
| 232,509 | 236,790 |
50.5%
| 45.3 | 50.9 |
56.9
| 63.2 | 70.6 |
2008
| 159,273 | 309,146 |
66.0%
| 45.3 | 50.6 |
56.1
| 61.6 | 68.0 |
Age group | Total 45-69 | Total 50-69 | ||||||
---|---|---|---|---|---|---|---|---|
45-49 | 50-54 | 55-59 | 60-64 | 65-69 | 70-74 | |||
Number of women screened | 95,883 | 106,232 | 105,578 | 90,394 | 55,427 | 4,848 | 453,514 | 357,631 |
Estimate of 24 m coverage by examination
|
58.0%
|
55.0%
|
51.6%
|
47.5%
|
42.3%
|
14.5%
|
51.2%
|
49.6%
|
Number of women with detected breast cancer | 254 | 374 | 416 | 577 | 409 | 67 | 2,030 | 1,776 |
Breast cancer detection rate
|
2.6
|
3.5
|
3.9
|
6.4
|
7.4
|
13.8
|
4.5
|
5.0
|
Number of women undergoing further assessment | 20,881 | 14,923 | 10,318 | 7,174 | 3,959 | 409 | 57,255 | 36,374 |
Further assessment rate
|
21.8%
|
14.0%
|
9.8%
|
7.9%
|
7.1%
|
8.4%
|
12.6%
|
10.2%
|
Number of women recalled for further assessment | 3,652 | 2,913 | 2,421 | 2,149 | 1,291 | 162 | 12,426 | 8,774 |
Recall rate
|
3.8%
|
2.7%
|
2.3%
|
2.4%
|
2.3%
|
3.3%
|
2.7%
|
2.5%
|
Women undergoing open biopsy - benign result | 50 | 40 | 27 | 31 | 21 | 1 | 169 | 119 |
Women undergoing open biopsy - malignant result | 211 | 315 | 368 | 481 | 334 | 58 | 1,709 | 1,498 |
Benign to malignant open biopsy ratio
|
0.24
|
0.13
|
0.07
|
0.06
|
0.06
|
0.02
|
0.10
|
0.08
|
Number of women with detected breast cancer (cases preceded by neoadjuvant therapy excluded)
| 239 | 352 | 401 | 555 | 399 | 65 | 1,946 | 1,707 |
Advanced cases (TNM II+) | 63 | 98 | 104 | 131 | 95 | 27 | 491 | 428 |
Advanced cases proportion
|
26.4%
|
27.8%
|
25.9%
|
23.6%
|
23.8%
|
41.5%
|
25.2%
|
25.1%
|
Invasive cases | 216 | 315 | 343 | 508 | 360 | 63 | 1,742 | 1,526 |
Invasive cases proportion
|
90.4%
|
89.5%
|
85.5%
|
91.5%
|
90.2%
|
96.9%
|
89.5%
|
89.4%
|
Node-negative invasive cases | 131 | 196 | 238 | 342 | 255 | 38 | 1,162 | 1,031 |
Proportion among invasive
|
60.6%
|
62.2%
|
69.4%
|
67.3%
|
70.8%
|
60.3%
|
66.7%
|
67.6%
|
Invasive ≤ 10 mm cases | 70 | 110 | 119 | 179 | 146 | 19 | 624 | 554 |
Proportion among invasive
|
32.4%
|
34.9%
|
34.7%
|
35.2%
|
40.6%
|
30.2%
|
35.8%
|
36.3%
|
Year (screening mammography) | |||||||
---|---|---|---|---|---|---|---|
2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | |
Number of women screened | 10,055 | 212,514 | 258,635 | 220,897 | 170,717 | 232,509 | 159,273 |
Number of women with detected breast cancer | 48 | 1,053 | 1,220 | 1,153 | 935 | 1,662 | 974 |
Breast cancer detection rate
|
4.8
|
5.0
|
4.7
|
5.2
|
5.5
|
7.1
|
6.1
|
Number of women undergoing further assessment | 1,768 | 46,973 | 56,961 | 44,919 | 33,135 | 39,921 | 30,239 |
Further assessment rate
|
17.6%
|
22.1%
|
22.0%
|
20.3%
|
19.4%
|
17.2%
|
19.0%
|
Number of women recalled for further assessment | 557 | 12,095 | 11,535 | 9,735 | 6,496 | 8,888 | 6,246 |
Recall rate
|
5.5%
|
5.7%
|
4.5%
|
4.4%
|
3.8%
|
3.8%
|
3.9%
|
Women undergoing open biopsy - benign result | 21 | 504 | 343 | 226 | 135 | 166 | 90 |
Women undergoing open biopsy - malignant result | 43 | 867 | 992 | 994 | 787 | 1,382 | 784 |
Benign to malignant open biopsy ratio
|
0.49
|
0.58
|
0.35
|
0.23
|
0.17
|
0.12
|
0.11
|
Number of women with detected breast cancer (cases preceded by neoadjuvant therapy excluded)
| 48 | 1,031 | 1,182 | 1,116 | 905 | 1,610 | 924 |
Advanced cases (TNM II+) | 17 | 331 | 384 | 367 | 284 | 465 | 277 |
Advanced cases proportion
|
35.4%
|
32.1%
|
32.5%
|
32.9%
|
31.4%
|
28.9%
|
30.0%
|
Invasive cases | 41 | 933 | 1,072 | 1,023 | 823 | 1,459 | 850 |
Invasive cases proportion
|
85.4%
|
90.5%
|
90.7%
|
91.7%
|
90.9%
|
90.6%
|
92.0%
|
Node-negative invasive cases | 27 | 572 | 682 | 644 | 525 | 909 | 535 |
Proportion among invasive
|
65.9%
|
61.3%
|
63.6%
|
63.0%
|
63.8%
|
62.3%
|
62.9%
|
Invasive ≤ 10 mm cases | 11 | 312 | 350 | 348 | 288 | 441 | 275 |
Proportion among invasive
|
26.8%
|
33.4%
|
32.6%
|
34.0%
|
35.0%
|
30.2%
|
32.4%
|
Age group | Total 45-69 | Total 50-69 | ||||||
---|---|---|---|---|---|---|---|---|
45-49 | 50-54 | 55-59 | 60-64 | 65-69 | 70-74 | |||
Number of women screened | 54,495 | 26,214 | 26,694 | 24,452 | 16,067 | 3,047 | 147,922 | 93,427 |
Number of women with detected breast cancer | 169 | 126 | 150 | 245 | 211 | 46 | 901 | 732 |
Breast cancer detection rate
|
3.1
|
4.8
|
5.6
|
10.0
|
13.1
|
15.1
|
6.1
|
7.8
|
Number of women undergoing further assessment | 14,188 | 5,097 | 3,749 | 2,998 | 1,808 | 306 | 27,840 | 13,652 |
Further assessment rate
|
26.0%
|
19.4%
|
14.0%
|
12.3%
|
11.3%
|
10.0%
|
18.8%
|
14.6%
|
Number of women recalled for further assessment | 2,430 | 1,007 | 845 | 901 | 626 | 124 | 5,809 | 3,379 |
Recall rate
|
4.5%
|
3.8%
|
3.2%
|
3.7%
|
3.9%
|
4.1%
|
3.9%
|
3.6%
|
Women undergoing open biopsy - benign result | 35 | 18 | 8 | 14 | 11 | 1 | 86 | 51 |
Women undergoing open biopsy - malignant result | 135 | 101 | 132 | 194 | 161 | 38 | 723 | 588 |
Benign to malignant open biopsy ratio
|
0.26
|
0.18
|
0.06
|
0.07
|
0.07
|
0.03
|
0.12
|
0.09
|
Number of women with detected breast cancer
(cases preceded by neoadjuvant therapy excluded)
| 159 | 115 | 144 | 233 | 205 | 44 | 856 | 697 |
Advanced cases (TNM II+) | 47 | 34 | 45 | 72 | 55 | 19 | 253 | 206 |
Advanced cases proportion
|
29.6%
|
29.6%
|
31.3%
|
30.9%
|
26.8%
|
43.2%
|
29.6%
|
29.6%
|
Invasive cases | 146 | 106 | 129 | 216 | 189 | 42 | 786 | 640 |
Invasive cases proportion
|
91.8%
|
92.2%
|
89.6%
|
92.7%
|
92.2%
|
95.5%
|
91.8%
|
91.8%
|
Node-negative invasive cases | 83 | 68 | 85 | 136 | 124 | 24 | 496 | 413 |
Proportion among invasive
|
56.8%
|
64.2%
|
65.9%
|
63.0%
|
65.6%
|
57.1%
|
63.1%
|
64.5%
|
Invasive ≤ 10 mm cases | 47 | 32 | 42 | 64 | 73 | 10 | 258 | 211 |
Proportion among invasive
|
32.2%
|
30.2%
|
32.6%
|
29.6%
|
38.6%
|
23.8%
|
32.8%
|
33.0%
|
Year (screening mammography) | |||||
---|---|---|---|---|---|
2004 | 2005 | 2006 | 2007 | 2008 | |
Number of women screened | 6,582 | 96,297 | 169,847 | 236,790 | 309,146 |
Number of women with detected breast cancer | 30 | 292 | 635 | 880 | 1,154 |
Breast cancer detection rate
|
4.6
|
3.0
|
3.7
|
3.7
|
3.7
|
Number of women undergoing further assessment | 964 | 11,931 | 20,445 | 23,494 | 29,786 |
Further assessment rate
|
14.6%
|
12.4%
|
12.0%
|
9.9%
|
9.6%
|
Number of women recalled for further assessment | 190 | 2,196 | 3,933 | 5,089 | 6,709 |
Recall rate
|
2.9%
|
2.3%
|
2.3%
|
2.1%
|
2.2%
|
Women undergoing open biopsy - benign result | 4 | 59 | 59 | 83 | 83 |
Women undergoing open biopsy - malignant result | 29 | 265 | 560 | 767 | 1,010 |
Benign to malignant open biopsy ratio
|
0.14
|
0.22
|
0.11
|
0.11
|
0.08
|
Number of women with detected breast cancer (cases preceded by neoadjuvant therapy excluded)
| 30 | 284 | 617 | 860 | 1,115 |
Advanced cases (TNM II+) | 6 | 73 | 155 | 187 | 248 |
Advanced cases proportion
|
20.0%
|
25.7%
|
25.1%
|
21.7%
|
22.2%
|
Invasive cases | 25 | 260 | 547 | 752 | 981 |
Invasive cases proportion
|
83.3%
|
91.5%
|
88.7%
|
87.4%
|
88.0%
|
Node-negative invasive cases | 18 | 196 | 380 | 533 | 683 |
Proportion among invasive
|
72.0%
|
75.4%
|
69.5%
|
70.9%
|
69.6%
|
Invasive ≤ 10 mm cases | 10 | 112 | 216 | 329 | 376 |
Proportion among invasive
|
40.0%
|
43.1%
|
39.5%
|
43.8%
|
38.3%
|
Age group | Total 45-69 | Total 50-69 | ||||||
---|---|---|---|---|---|---|---|---|
45-49 | 50-54 | 55-59 | 60-64 | 65-69 | 70-74 | |||
Number of women screened | 41,388 | 80,018 | 78,884 | 65,942 | 39,360 | 1,801 | 305,592 | 264,204 |
Number of women with detected breast cancer | 85 | 248 | 266 | 332 | 198 | 21 | 1,129 | 1,044 |
Breast cancer detection rate
|
2.1
|
3.1
|
3.4
|
5.0
|
5.0
|
11.7
|
3.7
|
4.0
|
Number of women undergoing further assessment | 6,693 | 9,826 | 6,569 | 4,176 | 2,151 | 103 | 29,415 | 22,722 |
Further assessment rate
|
16.2%
|
12.3%
|
8.3%
|
6.3%
|
5.5%
|
5.7%
|
9.6%
|
8.6%
|
Number of women recalled for further assessment | 1,222 | 1,906 | 1,576 | 1,248 | 665 | 38 | 6,617 | 5,395 |
Recall rate
|
3.0%
|
2.4%
|
2.0%
|
1.9%
|
1.7%
|
2.1%
|
2.2%
|
2.0%
|
Women undergoing open biopsy - benign result | 15 | 22 | 19 | 17 | 10 | 0 | 83 | 68 |
Women undergoing open biopsy - malignant result | 76 | 214 | 236 | 287 | 173 | 20 | 986 | 910 |
Benign to malignant open biopsy ratio
|
0.20
|
0.10
|
0.08
|
0.06
|
0.06
|
0.00
|
0.08
|
0.07
|
Number of women with detected breast cancer
(cases preceded by neoadjuvant therapy excluded)
| 80 | 237 | 257 | 322 | 194 | 21 | 1,090 | 1,010 |
Advanced cases (TNM II+) | 16 | 64 | 59 | 59 | 40 | 8 | 238 | 222 |
Advanced cases proportion
|
20.0%
|
27.0%
|
23.0%
|
18.3%
|
20.6%
|
38.1%
|
21.8%
|
22.0%
|
Invasive cases | 70 | 209 | 214 | 292 | 171 | 21 | 956 | 886 |
Invasive cases proportion
|
87.5%
|
88.2%
|
83.3%
|
90.7%
|
88.1%
|
100.0%
|
87.7%
|
87.7%
|
Node-negative invasive cases | 48 | 128 | 153 | 206 | 131 | 14 | 666 | 618 |
Proportion among invasive
|
68.6%
|
61.2%
|
71.5%
|
70.5%
|
76.6%
|
66.7%
|
69.7%
|
69.8%
|
Invasive ≤ 10 mm cases | 23 | 78 | 77 | 115 | 73 | 9 | 366 | 343 |
Proportion among invasive
|
32.9%
|
37.3%
|
36.0%
|
39.4%
|
42.7%
|
42.9%
|
38.3%
|
38.7%
|