Aim: The aim of the study is to analyse the regional and time range characteristics of the breast cancer screening programme and the utilization of health services related to the programme.
Methods: The data derive from the database of the National Health Insurance Fund Administration containing routinely collected financial data. The patients include all the women having mammography screening in the year of 2002 (N=314,395). In the time range analysis the starting point (T0) was the time of the mammography screening identified with the outpatient code "42400 mammography screening". We calculated the average delay between the time of mammography screening (time=T0), further diagnostic (time=T1) and therapeutic (time=T2) procedures. For the calculation of the average period spent from the time of mammography screening we used the median value instead of arithmetic mean.
Results: According to our data 17,303 women had ultrasound examination in axilla (T1 median value: 20 days) and 23,249 women had ultrasound examination in breast (T1 median value: 26 days). Among the women having mammography examination in 2002, 906 had chemotherapy (T2 median value: 83 days), while 1364 patients had radiotherapy (T2 median value: 136 days). The T2 median value of subtotal and total mastectomy was 43-47 days and 50-53 days respectively, while the T2 median value of breast operations because of non-malignant causes was 57 days after mammography screening. The total annual cost of organised breast cancer screening programme, including the cost of mammography examination, the cost of further diagnostic examination and surgical, radio- and chemotherapy treatment of recalled women, was 2,242 billion Hungarian forints (8,968 million euros) in 2002.
Conclusion: We observed significant regional differences, which result in large discrepancies in the equity. We can assume that these differences can be reduced by better organisation and the more consistent application of professional guidelines.