We performed a medical audit of the mammograms performed as part of the existing public cancer screening program to propose a plan for improving the program.

We analyzed the results of 3,317 mammograms performed between March 2006 and February 2007. The American College of Radiology Breast Imaging Reporting and Data System (ACR BI_RADS) guidelines were used for follow-up and outcome monitoring. Cases in categories 0, 4, and 5 were followed up by a review of the patient's medical records and a phone call survey to determine the reasons for not continuing with follow-up examinations.

The mean age of the women enrolled in this study was 51 years. The rate of recall was approximately 6.4% and the cancer detection rate was 2.1 out of every 1000 women examined. Positive predictive values (PPV) of 1, 2 and 3 were observed in 3.3%, 33.3% and 70.0%, respectively. The sensitivity and specificity were 100% and 93.8%, respectively. As a result of the phone-call survey to determine the reasons for not following up with additional examinations, 53.8% of cases were 'belittled since there was no subjective symptom,' and 16.3%, 'didn't check the cancer examination notice thoroughly or did not fully understand it'.

The result of medical audit indicates that reading and follow-up examinations were conducted in a relatively proper manner. Taking into consideration the characteristics of the objects for public examination, it is thought that active follow-up management as well as a written notice of the results, is necessary for patients who were found to be abnormal.