Korean J Radiol.
2025 Apr;26(4):313-323. 10.3348/kjr.2024.0866.
Biennial Mammography Performance in the Korean National Cancer Screening Program From 2009 to 2020
- Affiliations
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- 1Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- 2Department of Public Health, Graduate School, The Catholic University of Korea, Seoul, Republic of Korea
- 3Division of Social Welfare and Health Administration, Wonkwang University, Iksan, Republic of Korea
- 4National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- 5Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- 6Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- KMID: 2566226
- DOI: http://doi.org/10.3348/kjr.2024.0866
Abstract
Objective
Mammography is essential for reducing breast cancer mortality; however, its performance varies globally. This study aimed to evaluate mammography screening outcomes in Korea over 12 years and investigate regional variations.
Materials and Methods
We analyzed mammography data from 42 million Korean women, aged 40 years and older, who participated in the Korean National Cancer Screening Program (KNCSP) from 2009 to 2020. Performance metrics—including recall rate (RR), positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), cancer detection rate (CDR), interval cancer rate (ICR), and dense breast rate (DBR), were computed. Twelve-year trends in these metrics were analyzed using Joinpoint regression. Regional variations were also examined across Korea’s 237 districts, stratified by age groups.
Results
From 2009 to 2020, 42165405 mammography screenings were conducted through the KNCSP, increasing from 2821132 screenings in 2009 to 3596204 in 2020. The RR decreased from 17.2% in 2009 to 11.2% in 2020 (average annual percent change [AAPC] = -3.7%), while the PPV increased from 0.8% to 2.8%; AAPC = 10.7%), the CDR increased from 1.5 to 3.1 per 1000; AAPC = 7.3%), and the ICR rose from 0.9 to 1.6 per 1000; (AAPC = 5.2%). Regional variations were noted; however, differences in the RR, sensitivity, specificity, and FPR decreased over time.
Conclusion
While mammography performance improved from 2009 to 2020, the PPV and sensitivity remain suboptimal, underscoring the need for continuous monitoring. Regional disparities in performance, although reduced, persist. These findings provide essential baseline data for improving mammography quality and addressing inequities in breast cancer screening.
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