Blinded double reading yields a higher programme sensitivity than non-blinded double reading at digital screening mammography: A prospected population based study in the south of The Netherlands

E.G. Klompenhouwer*, A.C. Voogd, G.J. den Heeten, L.J.A. Strobbe, A.F.J. de Haan, C.A. Wauters, M.J.M. Broeders, L.E.M. Duijm

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Purpose: To prospectively determine the screening mammography outcome at blinded and non-blinded double reading in a;biennial population based screening programme in the south of the Netherlands.

Methods: We included a consecutive series of 87,487 digital screening mammograms, obtained between July 2009 and July 2011. Screening mammograms were double read in either a blinded (2nd reader was not informed about the 1st reader's decision) or non-blinded fashion (2nd reader was informed about the 1st reader's decision). This reading strategy was alternated on a monthly basis. Women with discrepant readings between the two radiologists were always referred for further analysis. During 2 years follow-up, we collected the radiology reports, surgical correspondence and pathology reports of all referred women and interval breast cancers.

Results: Respectively 44,491 and 42,996 screens had been read either in a blinded or non-blinded fashion. Referral rate (3.3% versus 2.8%, p

Conclusion: We advocate the use of blinded double reading in order to achieve a better programme sensitivity, at the expense of an increased referral rate and false positive referral rate. (C) 2014 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)391-399
Number of pages9
JournalEuropean Journal of Cancer
Issue number3
Publication statusPublished - Feb 2015


  • Breast cancer
  • Screening mammography
  • Double reading
  • Referral rate
  • Sensitivity
  • Positive predictive value
  • COST

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