Organizational impact of systemic implementation of digital breast tomosynthesis as a primary test for breast cancer screening in Italy
(2024) In Radiologia Medica 129(8). p.1156-1172- Abstract
Purpose: We present a comprehensive investigation into the organizational, social, and ethical impact of implementing digital breast tomosynthesis (DBT) as a primary test for breast cancer screening in Italy. The analyses aimed to assess the feasibility of DBT specifically for all women aged 45–74, women aged 45–49 only, or those with dense breasts only. Methods: Questions were framed according to the European Network of Health Technology Assessment (EuNetHTA) Screening Core Model to produce evidence for the resources, equity, acceptability, and feasibility domains of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) decision framework. The study integrated evidence from the literature, the MAITA DBT trials,... (More)
Purpose: We present a comprehensive investigation into the organizational, social, and ethical impact of implementing digital breast tomosynthesis (DBT) as a primary test for breast cancer screening in Italy. The analyses aimed to assess the feasibility of DBT specifically for all women aged 45–74, women aged 45–49 only, or those with dense breasts only. Methods: Questions were framed according to the European Network of Health Technology Assessment (EuNetHTA) Screening Core Model to produce evidence for the resources, equity, acceptability, and feasibility domains of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) decision framework. The study integrated evidence from the literature, the MAITA DBT trials, and Italian pilot programs. Structured interviews, surveys, and systematic reviews were conducted to gather data on organizational impact, acceptability among women, reading and acquisition times, and the technical requirements of DBT in screening. Results: Implementing DBT could significantly affect the screening program, primarily due to increased reading times and the need for additional human resources (radiologists and radiographers). Participation rates in DBT screening were similar, if not better, to those observed with standard digital mammography, indicating good acceptability among women. The study also highlighted the necessity for specific training for radiographers. The interviewed key persons unanimously considered feasible tailored screening strategies based on breast density or age, but they require effective communication with the target population. Conclusions: An increase in radiologists’ and radiographers’ workload limits the feasibility of DBT screening. Tailored screening strategies may maximize the benefits of DBT while mitigating potential challenges.
(Less)
- author
- contributor
- Lång, Kristina LU
- author collaboration
- organization
- publishing date
- 2024-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Breast neoplasms, Digital breast tomosynthesis, Digital mammography, Health technology assessment, Mass screening, Organizational impact
- in
- Radiologia Medica
- volume
- 129
- issue
- 8
- pages
- 1156 - 1172
- publisher
- Edizioni Minerva Medica
- external identifiers
-
- scopus:85201252422
- pmid:39042203
- ISSN
- 0033-8362
- DOI
- 10.1007/s11547-024-01849-0
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © Italian Society of Medical Radiology 2024.
- id
- 5a69e4e8-1a06-4a65-8f6a-39ec6b8a9b09
- date added to LUP
- 2024-09-28 08:52:04
- date last changed
- 2024-10-02 14:42:22
@article{5a69e4e8-1a06-4a65-8f6a-39ec6b8a9b09,
abstract = {{<p>Purpose: We present a comprehensive investigation into the organizational, social, and ethical impact of implementing digital breast tomosynthesis (DBT) as a primary test for breast cancer screening in Italy. The analyses aimed to assess the feasibility of DBT specifically for all women aged 45–74, women aged 45–49 only, or those with dense breasts only. Methods: Questions were framed according to the European Network of Health Technology Assessment (EuNetHTA) Screening Core Model to produce evidence for the resources, equity, acceptability, and feasibility domains of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) decision framework. The study integrated evidence from the literature, the MAITA DBT trials, and Italian pilot programs. Structured interviews, surveys, and systematic reviews were conducted to gather data on organizational impact, acceptability among women, reading and acquisition times, and the technical requirements of DBT in screening. Results: Implementing DBT could significantly affect the screening program, primarily due to increased reading times and the need for additional human resources (radiologists and radiographers). Participation rates in DBT screening were similar, if not better, to those observed with standard digital mammography, indicating good acceptability among women. The study also highlighted the necessity for specific training for radiographers. The interviewed key persons unanimously considered feasible tailored screening strategies based on breast density or age, but they require effective communication with the target population. Conclusions: An increase in radiologists’ and radiographers’ workload limits the feasibility of DBT screening. Tailored screening strategies may maximize the benefits of DBT while mitigating potential challenges.</p>}},
author = {{Djuric, Olivera and Deandrea, Silvia and Mantellini, Paola and Sardanelli, Francesco and Venturelli, Francesco and Montemezzi, Stefania and Vecchio, Riccardo and Bucchi, Lauro and Senore, Carlo and Giordano, Livia and Paci, Eugenio and Bonifacino, Adriana and Calabrese, Massimo and Caumo, Francesca and Degrassi, Flori and Sassoli de’ Bianchi, Priscilla and Battisti, Francesca and Zappa, Marco and Pattacini, Pierpaolo and Campari, Cinzia and Nitrosi, Andrea and Di Leo, Giovanni and Frigerio, Alfonso and Magni, Veronica and Fornasa, Francesca and Romanucci, Giovanna and Falini, Patrizia and Auzzi, Noemi and Armaroli, Paola and Giorgi Rossi, Paolo and Falcini, Fabio and Lang, Kristina and Graewingholt, Axel and Duffy, Stephen W. and Vergini, Viviana and Pitarella, Sabina and Casella, Denise and Riggi, Emilia and Castellano, Isabella and Di Leo, Aurora and Artuso, Franca and Milanesio, Luisella and Marra, Vincenzo and Correale, Loredana and Ponti, Antonio and Segnan, Nereo and Presti, Pietro and Falco, Paolo and Dettori, Davide and Favettini, Elisabetta}},
issn = {{0033-8362}},
keywords = {{Breast neoplasms; Digital breast tomosynthesis; Digital mammography; Health technology assessment; Mass screening; Organizational impact}},
language = {{eng}},
number = {{8}},
pages = {{1156--1172}},
publisher = {{Edizioni Minerva Medica}},
series = {{Radiologia Medica}},
title = {{Organizational impact of systemic implementation of digital breast tomosynthesis as a primary test for breast cancer screening in Italy}},
url = {{http://dx.doi.org/10.1007/s11547-024-01849-0}},
doi = {{10.1007/s11547-024-01849-0}},
volume = {{129}},
year = {{2024}},
}