Population-based mammography screening for early breast cancer detection in the Soacha municipality, Cundinamarca: A success story

Abstract

Introduction: screening mammography is practiced in Colombia as part of the Mandatory Health Plan since 2000, using random twice a year screening in women between 50 and 69 years of age. It was not until January 1st, 2012 when health care benefits were standardized, that women were entitled to subsidized health care. Objective: to discuss the benefits of implementing a population-based (organized) mammography screening program for women between 40 to 49 years of age, as a complement to opportunity screening. Methodology: a public policy that removed all administrative hurdles was designed and various induced demand strategies were deployed. The procedures were adapted to the recommendations of the National Cancer Institute. Results: of the 6,560 women, the program provided coverage for 5,472 women (83.4%). Of the total number of women screened, six were diagnosed with cancer (0.1%). The average opportunity for the program was 6 days. The time elapsed between the diagnostic confirmation and the specialist’s evaluation was 34 and 62 days, respectively. Four cases were identified as Stages I and IIA (66.6%), which are good prognostic tumors with no metastatic involvement; and two cases (33.4%) were stage IIIA with axillary lymph node involvement. Conclusions: the results showed the benefits of a population-based screening program, and its technical and financial feasibility, as opposed to the current opportunity programs that provide a maximum coverage of 20% of the population.