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Breast Cancer Screening Quality

Key findings

  • In 2017, the positive predictive value (PPV) of breast cancer screening was 6.5% in the Ontario Breast Screening Program (OBSP).
  • A PPV of 6.5% means that 3,686 of 56,813 women ages 50 to 74 who had an abnormal Ontario Breast Screening Program screening mammogram were diagnosed with breast cancer.
  • This measure has remained steady at about 6.5% since 2014.

Why is this important to Ontarians?

  • The positive predictive value (PPV) of breast cancer screening shows the likelihood of a participant having an abnormal screening mammogram and being diagnosed with breast cancer.

See Breast Cancer Screening Quality Methodology for technical information.


Report date: December 2018
Data source: Ontario Health Insurance Plan (OHIP) Claims History Database (CHDB), Integrated Client Management System (ICMS), Ontario Cancer Registry (OCR), Ontario Registered Persons Database (RPDB), Postal Code Conversion File Plus (PCCF+ version 6D)
Prepared by: Analytics, Cancer Screening, Prevention and Cancer Control, Cancer Care Ontario
 

Data Table 1: Percentage of Ontario screen-eligible women, ages 50 to 74 years, with an abnormal Ontario Breast Screening Program (OBSP) screening mammogram result who were diagnosed with breast cancer (ductal carcinoma in situ or invasive) after diagnostic work-up, 2014 to 2017
Year Percentage (%)
2014 6.4
2015 6.4
2016 6.5
2017 6.5


Report date: December 2018
Data source: Ontario Health Insurance Plan (OHIP) Claims History Database (CHDB), Integrated Client Management System (ICMS), Ontario Cancer Registry (OCR), Ontario Registered Persons Database (RPDB), Postal Code Conversion File Plus (PCCF+ version 6D)
Prepared by: Analytics, Cancer Screening, Prevention and Cancer Control, Cancer Care Ontario

Results

  • The overall positive predictive value (PPV) of breast cancer screening in the Ontario Breast Screening Program (OBSP) has remained steady over time, but it varies by age group.
  • In 2017, approximately 3,700 of the over 57,000 Ontario women ages 50 to 74 who had an abnormal OBSP screening mammogram result were diagnosed with breast cancer.
  • In 2017, the overall PPV of OBSP screening mammograms was 6.5%. The PPV has remained relatively stable since 2014, at about 6.5%.
  • The PPV increases with age. Similar to previous years, in 2017, the PPV of Ontario Breast Screening Program screening mammograms was highest in women ages 70 to 74 (11.8%) and lowest in women ages 50 to 54 (3.1%). Women in higher age groups have received more screens over their lifetimes, which leads to an increased PPV.

Opportunities

  • Each year, the Ontario Breast Screening Program (OBSP) sends a Radiologist Outcome Report to each radiologist in the program. The report includes data on their key performance metrics including positive predictive value (PPV). Radiologists who perform below the program’s PPV target receive a letter notifying them that they are below the target. These radiologists are encouraged to identify ways to improve their PPV.
  • Annually, mammography quality reports are generated at the facility, regional, physician and provincial levels. These reports highlight performance on various quality standards and indicators for average risk screening mammography, including positive predictive value (PPV). Reports are accompanied by resources to support quality improvement.