Film Screen Mammography Should Remain the Standard for Detecting Breast Cancer, CCOHTA Report Concludes

November 11, 2002

OTTAWA - Conventional film screen mammography, the current standard for detecting breast cancer, is preferable to digital mammography at this time, a technology assessment released today by the Canadian Coordinating Office for Health Technology Assessment concludes.

Based on a review of published and unpublished studies, CCOHTA compared the technical, clinical and potential costs of digital mammography (DM) and film screen mammography (FSM) within the context of the Canadian health care system. The technical review was based on 37 relevant articles, the clinical study on 7, and the economic analysis on 17.

Two different digital technologies were considered. Digital radiography mammography (DR-M) is a direct system - X-ray information is directly converted into a digital image. Total annualized capital and operating costs for a single DR-M may be as much as $249,000 more than FSM. Computed radiography mammography (CR-M) is an indirect system - X-ray information is captured on a detector plate from which a digital image is created. Total annualized capital and operating costs for CR-M are substantially equivalent to FSM.

The potential clinical benefits of DM (improved diagnostic accuracy, shorter examination time, lower radiation dose) for patients, institutions and payers have not been demonstrated in a clinical setting. The ability to detect cancer is comparable for DR-M and FSM. There is insufficient evidence to judge the comparative clinical effectiveness of CR-M.

Since there is no evidence that DM is clinically superior, the minimum cost system is preferable at this time, the report concludes.

Breast cancer is the most common cancer to affect women. Each year in Canada an estimated 19,500 women are diagnosed with breast cancer and 5,500 die from it.

This publication is available online.

For further information contact Kirk Fergusson: 613 226-2553 ext. 276