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© 1998 Oxford University Press
review-article |
Breast cancer screening programmes in 22 countries: current policies, administration and guidelines
aJohns Hopkins University School of Hygiene and Public Health Baltimore, MD, USA
bUniversity of Arkansas for Medical Sdences Little Rock, AR, USA
cEUREF, University Hospital Nljmegen. and the National Evaluation Team for Breast (,ancer Screening (NETB) The Netherlands
dMater Misericordia Hospital Dublin, Ireland
eErasmus Unlversitelt Rotterdam, and the NETB. The Netherlands
finstitute of Cancer Research Surrey, UK
g8Centro per lo Studio e la Prevenzione Oncologica Plrenze. Italy
hHealth Canada Ottawa, Canada
iNational Cancer Institute (NCJ) Bethesda. MD, USA
jMembers of the IBSN in 1995: F Parker, Australia; S Stachenko, Canada; M Hakarna, Finland; K Pefli, Hungary; BF Slgf{diaeresis}sson, Iceland G Rermert Israet, B Pact, Italy; N Ohuchi. Japaa, HJ de Koning, J Fracheboud, The Netherlands; H Mahnqulst Sr. Sweden S Moss, UK; G Pou, Uruguay; R Ballard-Barbasb, USA
kMembers of the European Network of Pilot Projects for Breast Cancer Screening: A Grlvegnée, A Van Assche, Belgium; E Lynge, Denmark. B Gairard, P Schaffer, B Seradour, France; D von Fournier, Germany; I Garas. A Linus, Greece; M Codcl. Ireland,' E Pad. Italy; S Batal-Stell, Luxembourg; VL Rodiigues, JB da Roche Alves, Portugal; N Ascunce, Spain
Reprint requests: Rachel Baflard-Barbash, DCCPS/NCI/NIH. Executive Plaza North, Room 313, 6130 Executive Blvd MSC 7344, Bethesda, MD 20892-7344, USA
BACKGROUND: Currently there are at least 22 countries worldwide where national, regional or pilot population-based breast cancer screening programmes have been established. A collaborative effort has been undertaken by the International Breast Cancer Screening Network (IBSN), an international voluntary collaborative effort administered from the National Cancer Institute in the US for the purposes of producing international data on the policies, funding and administration, and results of population-based breast cancer screening.
METHODS: Two surveys conducted by the IBSN in 1990 and 1995 describe the status of population-based breast cancer screening in countries which had or planned to establish breast cancer screening programmes in their countries. The 1990 survey was sent to ten countries in the IBSN and was completed by nine countries. The 1995 survey was sent to and completed by the 13 countries in the organization at that time and an additional nine countries in the European Network.
RESULTS: The programmes vary in how they have been organized and have changed from 1990 to 1995. The most notable change is the increase in the number of countries that have established or plan to establish organized breast cancer screening programmes. A second major change is in guidelines for the lower age limit for mammography screening and the use of the clinical breast examination and breast sell-examination as additional detection methods.
CONCLUSIONS: As high quality population-based breast cancer screening programmes are iiriplemented in more countries, they will offer an unprecedented opportunity to assess the level of coverage of the population for initial and repeat screening, evaluation of performance, and, in the longer term, outcome of screening in terms of reduction in the incidence of late-stage disease and in mortality.
Keywords Breast cancer, screening, population-based, database, guidelines, policies
Accepted 4 January 1998
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