Download Breast Cancer Screening (Indicator Set: Primary Health Care

Breast Cancer Screening
(Indicator Set: Primary Health Care Providers)
Descriptive
Definition
Percentage of female patient population, age 50 to 74, who had a
mammogram ordered.
Method of
Calculation
Numerator
Number of individuals in the denominator who had a
mammogram ordered within the past 36 months.
Inclusions
• Individual is in the denominator
• Individual had a mammogram ordered within the
past 36 months
Exclusions
None
Denominator
Number of female primary health care (PHC) clients/
patients age 50 to 74.
Inclusions
• PHC client/patient
• Sex of individual is female
• Age of individual is between 50 and 74 years
Exclusions
•
Individual has had a bilateral mastectomy
Data Source
Electronic medical record
Notes
Definitions of Terms
• A PHC client/patient is an individual who has had contact with the
provider at least once in the past year and has a record with the
provider dating back at least two years.
Interpretation
• A high rate for this indicator can be interpreted as a positive result.
• This indicator measures only individuals who have had a
mammogram ordered as documented in the electronic medical record.
The indicator does not measure whether the individual received the
mammogram (for example, patient refusal).
Breast Cancer Screening
(Indicator Set: Primary Health Care Providers) (cont’d)
Indicator Rationale Breast cancer is the most common cancer among Canadian women, with
an estimated 23,400 new cases occurring in 2011,1 comprising more
than 30% of all new cancer diagnoses in women age 20 to 69, and 20%
in women age 70 and older. One in 9 Canadian women will be diagnosed
with breast cancer in their lifetime, and 1 in 27 will die of the disease.2
Early detection of breast cancer is an important strategy that will yield
more treatment options and improve outcomes for women diagnosed
with the disease. Breast cancer mortality has been steadily declining in
Canada over time, especially for women younger than age 60. These
declines are generally the result of improvements in breast cancer
screening, including organized screening programs, increased
participation rates, the improved quality of mammography and
improvements in breast cancer therapy.2
The Canadian Task Force on Preventive Health Care in 2011
recommended new screening guidelines for women age 40 to 74 at
average risk of developing breast cancer (defined as those with no
previous breast cancer, no history of breast cancer in a first-degree
relative, no known mutations in the BRCA1/BRCA2 genes or no previous
exposure of the chest wall to radiation).3 The guidelines recommend
routine screening with mammography every two to three years for
women age 50 to 74.3, 4
The PHC provider plays an essential role in helping to detect breast
cancer early in the progression of the disease by recommending breast
cancer screening for his or her patients and monitoring screening results.
References
1.
Canadian Cancer Society’s Steering Committee on Cancer
Statistics. Canadian Cancer Statistics 2011. Toronto, ON: Canadian
Cancer Society; 2011. www.cancer.ca/statistics.
2.
Canadian Cancer Society/National Cancer Institute of Canada.
Canadian Cancer Statistics 2007. Toronto, ON: Canadian Cancer
Society; 2007.
3.
Tonelli M, Gorber SC, Joffres M, et al. Recommendations on
screening for breast cancer in average-risk women aged 40-74
years. CMAJ. November 22, 2011;183(17):1991-2001.
PM:22106103.
4.
Canadian Task Force on Preventive Health Care. Screening for
Breast Cancer. http://www.canadiantaskforce.ca/recommendations/
2011_01_eng.html. Accessed February 8, 2012.
For more information on the PHC indicators, data sources and reporting initiatives, visit CIHI’s
website at www.cihi.ca/phc or send us an email at [email protected].
2