Initiating a National Mammographic Screening Program: The Kuwait Experience Training With a US Cancer Center

J Am Coll Radiol. 2019 Feb;16(2):202-207. doi: 10.1016/j.jacr.2018.07.025. Epub 2018 Sep 25.

Abstract

Purpose:: To train Kuwait radiologists and technologists in breast imaging to create a Kuwait national mammography screening program (KNMSP) that provides high quality safe mammography services meeting international standards for early detection of small invasive breast cancers in asymptomatic women.

Materials and Methods:: 5 radiologists, 6 technologists and 1 physicist/radiation protection technologist from Kuwait trained at x hospital over a 3 year period utilizing Society of Breast Imaging/American College of Radiology guidelines and Food and Drug Administration Mammography Quality Standards Act requirements for education program content. On site visits in Kuwait were provided by x hospital radiologists and technologists 3 times during the program. The KNMSP was implemented to provide asymptomatic women ages 40–69 screening mammography services. A lead Kuwaiti breast radiologist collected and analyzed mammography results and outcome data utilizing descriptive statistics.

Results:: 6933/164000 (4.2%) Kuwaiti women were screened with 83 cancers detected, 74 invasive and 9 ductal carcinoma in situ. Screening mammography sensitivity was 97.6%, specificity 88.2%, and PPV3 37.1%. Diagnosis was stage 0 in 9/83 (10.8%), Stage 1 in 24/83(28.9%), Stage 2 in 34/83 (41%), Stage 3 in 11/83 (13.3%) and Stage 4 in 5/83 (6.0%). 80% of women with breast cancer were diagnosed with tissue biopsy within 4 weeks of their screening mammogram.

Conclusion:: The KNMSP demonstrates the successful training of Kuwait radiologists and mammography technologists with implementation of a national screening mammography program in Kuwait with acceptable sensitivity and specificity and timely diagnosis of early stage breast cancers.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / epidemiology
  • Early Detection of Cancer*
  • Female
  • Humans
  • International Educational Exchange*
  • Kuwait / epidemiology
  • Mammography / standards*
  • Mass Screening / organization & administration*
  • Middle Aged
  • Radiology / education*
  • United States