Kuwait National Mammography Screening Program: outcomes of 5 years of screening in Kuwaiti women

Abstract

BACKGROUND: Breast cancer is the most common malignancy among women in Kuwait, representing 39.8% of all female cancer cases. OBJECTIVES: Report the data of the Kuwait National Mammography Screening Program (KNMSP) for a 5-year period. DESIGN: Prospective data collection. SETTING: Population-based screening. SUBJECTS AND METHODS: We included mammography screens done for Kuwaiti women (age 40 years and older) who attended the KNMSP from 2014 to 2019 to screen for breast cancer. A full-field digital mammography system was used to acquire the mammographic images in craniocaudal and mediolateral oblique projections. Independent double-blind reading of the mammograms was performed by two radiologists. MAIN OUTCOME MEASURE: Early detection of breast cancer. SAMPLE SIZE: 14 773 asymptomatic women met inclusion criteria (mean [SD] age, 51.8 (8.2). RESULTS: Lesions were detected in 551 women (3.7%). These included 233 malignant lesions (233/551, 42.3%), 57 high-risk lesions (10.3%) and 261 benign lesions (47.4%). The participation rate was 7.8% of the target population of women 40–69 years of age. The majority of breast cancer cases were reported in the age group 45–49 years (23.2%). The KNMSP study recall rate for 5 consecutive years was in a range of 11.9–16.5% (mean, 14.3%). The detection rate of ductal/lobular carcinoma in situ and invasive breast cancer were 2.5 and 13.6 per 1000 screened women, respectively. Invasive ductal carcinoma was the most common type. Only 4314 women followed up within 12–15 months of the first mammography for a retention rate of 29.2%. CONCLUSIONS: Screening mammography improves early detection of breast cancer in women older than 40 years but poor participation is a limitation. We are aiming to increase the participation rate to 70% of the population. LIMITATIONS: Lack of participation by women. CONFLICT OF INTEREST: None.