Summary
For several years now, substantial efforts have been devoted to the development and the implementation of a screening program for breast cancer in the Canton of Vaud. A four-year pilot phase is now starting, involving two regional hospitals with their catchment areas; women over 50 and under 70 years old will be invited to participate in the program. A double view mammography will be made, with a double reading made by the hospital radiologists; a third reading will be made in case of discrepancy between the two first radiologists. Patients classified as positive for screening (e.g., with a suspect radiological image) will be referred to their practitioner for further diagnosis and treatment. The medical and public health background of this program is discussed, more specifically the reasons for developing a screening program, the choice of mammography rather than other tools, and the need to implement screening as an organized program.
Résumé
Depuis plusieurs années, un groupe réunissant les compétences de plusieurs disciplines médicales examine les possibilités d'implanter le dépistage du cancer du sein dans le Canton de Vaud. Un projet-pilote d'une durée de 4 ans va démarrer dans deux zones sanitaires du canton, adressé aux femmes âgées entre 50 et 70 ans: il s'agira d'une mammographie à double incidence et double lecture (avec une troisième lecture en cas de discordance entre les radiologues hospitaliers). Les femmes classées positives après l'examen de dépistage seront transférées à leur médecin traitant pour le diagnostic et, le cas échéant, le traitement. Le contexte médical et sanitaire de ce programme est discuté, en particulier les raisons spécifiques qui ont poussé les promoteurs à développer un programme organisé de dépistage par mammographie.
Zusammenfassung
Vertreter verschiedener medizinischer Fachgebiete bemühen sich seit einigen Jahren darum, für den Kanton Waadt ein Früherfassungsprogramm für den Brustkrebs auf die Beine zu stellen. In zwei Regionen des Kantons wird nun ein Pilotprojekt gestartet, das sich an die 50 bis 70jährigen Frauen richtet und vier Jahre dauern soll. Angeboten wird eine Mammographie in zwei Ebenen, die von zwei Röntgenologen unabhängig voneinander beurteilt werden wird (kommen die beiden Experten zu unterschiedlichen Beurteilungen, wird eine dritte Meinung eingeholt). Bei einem positiven Befund wird die betroffene Frau dem Hausarzt überwiesen, der die diagnostischen Abklärungen und nötigenfalls die Behandlung einleiten wird. Die medizinischen Grundlagen und der epidemiologische Hintergrund werden dargestellt; speziell erwähnt werden die Gründe für die Entwicklung eines Früherfassungsprogrammes und für die Wahl der Mammographie als Screeningmethode.
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Paccaud, F. Mammographic screening for breast cancer: Background of a pilot program in the Canton of Vaud. Soz Präventivmed 38, 288–293 (1993). https://doi.org/10.1007/BF01359590
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DOI: https://doi.org/10.1007/BF01359590