Mammography screening (Breast cancer screening), survey data and programme data (Source OECD HEALTH DATA 2008, December 08)

Australia, Austria, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Korea, Luxembourg, Mexico, Netherlands, New Zealand, Norway, Poland, Portugal, Slovak Republic, Spain, Sweden, Switzerland, Turkey, United Kingdom, United States,

Mammography screening - Breast cancer screening, survey data and programme data

Mammography rates.

Numerator: Number of women aged 50-69 reporting having received a bilateral mammography according to the specific screening frequency recommended in each country.
Denominator: Number of women aged 50-69 answering survey questions on mammography or eligible for organised screening programme.

Note: in most countries, the recommended screening frequency will be every year or every two years.

Sources and Methods

Summary table

Programme data		Survey data
Australia	Luxembourg	Austria
Belgium	Netherlands	France
Canada	New Zealand	Italy
Czech Republic	Norway	Korea
Finland	Portugal	Mexico
Hungary	Slovak Republic	Poland
Iceland	Sweden	United States
Ireland	United Kingdom
Japan

Australia

Australian Institute of Health and Welfare 2007. BreastScreen Australia monitoring report 2003-2004. AIHW Cat. No. CAN31. Canberra: AIHW (and previous issues). Also at www.aihw.gov.au.
* Population: National, representative sample.
* Age variation: 50-69.
* Programme or survey: programme.
* Recall period/periodicity: 2 years.
* The data are crude rates, and represent the proportion of women in the target population participating in the national screening programme over a 24-month period, hence the 2004 rate refers to both 2003 and 2004.

Austria

* 2006/2007: Austrian Health Interview Survey.
The survey will be repeated every 5 years.
* Recall period: past 12 months.
* Recommended periodicity: every two years for women aged 40 years and over.
* Denominator: number of women aged 50 to 69 years answering the Austrian Health Interview Survey.

Belgium

Programme de Dépistage du Cancer du Sein. Periods 2001-2002 and 2003-2004. Report number 4 from the Agence Intermutualiste. September 2006 (http://www.nic-ima.be/).
* Population: National.
* Age variation: 50-69.
* Programme or survey: programme.

Canada

Survey Data
Statistics Canada, National Population Health Survey, 1996/97 and 1998-99 and Canadian Community Health Survey, 2000/01, 2003 and 2005.
* Population: National, representative sample.
* Age variation: 50-69.
* Recall period/periodicity: 2 years.
* The percentage of females aged 50 to 69 who received routine screening mammogram or who received mammogram within the last two years for other reasons. The breakdown is as follows:

Year	Received routine screening Mammogram	Received mammogram for other reasons	Total
1996/97	49.4%	12.1%	61.5%
1998/99			66.3%
2000/01	54.8%	17.7%	69.5%
2003/04	49.1%	21.6%	70.6%
2005/06	50.8%	19.6%	70.4%

Programme Data: Health Canada, Organized Breast Cancer Screening Programs in Canada, 1999 and 2000 Report (2003).
Public Health Agency of Canada, Organized Breast Cancer Screening Programs in Canada, Report on Program Performance in 2001 and 2002 (2005).
* For the purposes of the Canadian Breast Cancer Screening Database (CBCSD), the target population is defined as asymptomatic women between the ages of 50 and 69 years with no prior diagnosis of breast cancer. All provincial /territorial programmes screen some women outside the target age group, although they are not actively recruited. In 1999 and 2000, the percentage of total screens that were delivered to women aged 50 to 69 ranged by province from 50.3% to 100%. In 2001 and 2002, it ranged from 51.1% to 100.0%.
* While some provinces are delivering the vast majority of their breast screening services through organized programs, Canada-wide data indicates that a considerable proportion of screening is delivered through the fee-for-service sector.

Czech Republic

National Breast Cancer Screening Database
* Processor: Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science of the Masaryk University, see http://www.iba.muni.cz.
* Population: The database comprises all examinations performed in accredited screening centres participating in the National breast cancer screening programme in the Czech Republic. For the year 2003 and for the first quarter of 2004, only estimation from aggregated data for one centre.
* Age variation: percentage of women at age 50-69 years screened in a given year.
* Programme or survey: programme. But survey data for 2002 is also provided.

Denmark

* Data not available.

Finland

National screening programme.
* Population: national, representative sample
* Age variation: 50-59 up to 2006; 50-69 since 2007.
* Programme or survey: programme.
* Recall period/periodicity: 2 years.
* Comments: Finnish public health statutes: the screening interval is two years, and it covers the population between 50 and 69 years, since 2007and 50-59 years until end of 2006. The Finnish health information system collects information on cancer screening from individuals, based on issued personal invitations to undergo screening. With the help of personal identification numbers, it is possible to follow up all invited women to know how many participated in the cancer screening.
In year 2005, 99% of women aged 50-59 (target age) were invited for organised cervical cancer screening and 87% participated (71% of those invited). In addition, some municipalities also invited women aged 60-64 or 65-69 years (34% and 18% respectively) and 88% and 86% of those invited participated, respectively.

France

For 2003 data: National Health Survey, INSEE.
* Population: National, representative sample.
* Age variation: 50-69.
* Programme or survey: survey.
* Recall period/periodicity: 2 years.
For 2006 data: Survey on health and social protection, IRDES (www.irdes.fr).
* Age variation: 50-74.
* Programme or survey: survey.
* Recall period/periodicity: 2 years.
* The Institut de Recherche et Documentation en Economie de la Santé (IRDES) carries out every couple of years a survey on health and social protection ("Enquête sur la santé et la protection sociale (ESPS)") which includes data on mammography rates. But the numerator and denominator are different of those of OECD: - Numerator: Number of women aged 50-74 reporting having received a bilateral mammography within the two last years. - Denominator: Number of women aged 50-74 answering survey questions on mammography or eligible for organised screening programme.

Germany

* Data not available.

Greece

* Data not available.

Hungary

Hungarian National Health Insurance Fund (OEP). www.oep.hu.
* Population: National.
* Age variation: 45-65.
* Programme or survey: programme.
* Recall period/periodicity: 2 years.
* Comments: organised screenings for breast cancer started in January 2002 in Hungary.

Iceland

Cancer Detection Centre of the Icelandic Cancer Society, Ministry of Health.
* Population: National, full population.
* Age variation: 40-69.
* Programme or survey: programme.
* Recall period/periodicity: 2 years.

Ireland

Breastcheck.
* Population: Regional. Half of national female population aged 50 to 64 currently covered by programme since 2000.
* Age variation: 50-64.
* Programme or survey: programme.
* Recall period/periodicity: 2 years.

Italy

* Source:
- Since 2004: Ministry of Health.
- Data referred to 2004-2006: Ministry of Health - National Centre for Screening Monitoring.
http://www.osservatorionazionalescreening.it/eng/about_us.htm.
Coverage:
- In 2004, target population corresponds to 52,0% of resident women aged 50-69 years old.
- In 2005, target population corresponds to 50,3% of resident women aged 50-69 years old.
- In 2006, target population corresponds to 57,6% of resident women aged 50-69 years old.
Periodicity: yearly.
Calculation method:
Numerator: Number of women aged 50-69 that have received a bilateral mammography through an annual organised programme within the past year.
Denominator: Number of women aged 50-69 involved in organised screening programme.
*

Data referred to 2000: ISTAT. Indagine Multiscopo Sulle Famiglie. Condizioni di salute e ricorso ai servizi sanitari. Roma 2002.
* The data referred to 2000 comes from population-based surveys.
* Population: National, representative sample. Age variation: 55-69.
* Programme or survey: survey.
* Recall period/periodicity: 2 years.
* Comments: Numerator is an estimation of the number of Italian women who have undergone a preventive mammography over the past two years. Refers to all mammographies performed either within or outside of organised programmes. Denominator is a proxy of Italian women in the same age range (55-69). Data collected as a result of a Multipurpose National Survey on Health Condition interviewing a representative sample of Italian women about preventive practices. Women aged 50-69 are invited to a screening mammography every two years. Coverage from screening programmes was estimated to be near 47% in 2001 and the mean value of participation in Italian Breast Screening Programs is 53.6%. Mammographies executed inside screening programmes in 2001 were 567,224 (Source: Osservatorio Nazionale per la Prevenzione dei Tumori Femminili. Secondo Rapporto, Lega Italiana per la Lotta contro i Tumori, 2003).

Japan

Japan National Voluntary Cancer Registry.
* Population: National, full population.
* Age variation: 50-69.
* Programme or survey: programme.
* Recall period/periodicity: 2 years.
* Comments: Data may underestimate mammography rates because estimates do not include other mass screening programmes such as work-site health maintenance programmes or health check-ups paid by recipients. A clinical breast exam was recommended for women aged 30 and over in Japan and mammography has not been on the list of cancer screening programme. Mammography was introduced among women aged 50 and over in 2000. The target population of mammography screening was expanded to women aged 40 and over in 2004.

Korea

Institute for Health and Social Affairs, Report on the National Health and Nutrition Survey in 2005 and 2006.
* Population: National, representative sample.
* Age variation: 50-69.
* Programme or survey: survey.

Luxembourg

* Since 1992, a national screening programme for breast cancer has been in place, under the common responsibility of the Ministère de la Santé and the Union des Caisses de maladie.
* Population: national, female population residing in Luxembourg and covered by sickness insurance.
*

Age variation: 50-64 years old (for 2000 data), 50-69 years old (since 2001).
* Programme or survey: programme.
* Recall period/periodicity: 2 years.
* Comments: every two years, women are invited to undergo two mammographies for each breast in one of Luxembourg's clinics.

Mexico

National Survey on Health and Nutrition 2006. Ministry of Health. National Institute of Public Health. Final results:
* Age variation: 50-69.
* Programme or survey: survey.
* Results are from 48,000 households. Data included 32 states. The survey is representative at national and state level.
* Comments: Data corresponds to the percentage of women aged 50 to 69 years old, who attended the preventive medicine module for detection of breast cancer (mammography) during the last 12 months.

Netherlands

Survey data from 2001 onwards: Statistics Netherlands, Health Interview Survey.
* Women who had a mammography at least once during the last two years.
Programme data: LETB, Landelijk Evaluatie Team voor bevolkingsonderzoek naar Borstkanker (National Evaluation Team for Breast Cancer Screening NETB), Landelijke evaluatie van bevolingsonderzoek naar bortskanker in Nederland. 2002 (X)Het tiende evaluatierapport en 2004 Tussenrapportage. (National evaluation of breast cancer screening in the Netherlands. 2002 (X) Tenth evaluation report and 2004 Interim report). Rotterdam: LETB, Erasmus MC, 2002, 2004. * Population: National, full population.
* Age variation: 50-75.
* Programme or survey: programme.
* Recall period/periodicity: 2 years.
* Comments: Netherlands Bevolkingsonderzoek naar Borstkanker (Breast Cancer screening programme in the Netherlands.) Every two years women aged 50-75 are invited for screening. In 2002 the target population was 1 090 000. Actual invited population was 1 059 000. Women who do not respond, receive a reminder invitation after 2-3 months. Women who declared they did not want an invitation anymore (definite refusers) and women with an interval or screening carcinoma do not receive an invitation for subsequent screens. The screening is organised and carried out by nine regional screening organisations. All invitations, screen examinations and screen results are recorded at the individual level in the regional information systems. The screening organisations are connected to the computerised municipal population registry that provide address details of the eligible women and information on whether these women have died or moved out of the region.

New Zealand

BreastScreen Aotearoa.
* Population: National, general sample.
* Age variation: 50-64. Changed to 45 - 69 July 2004
* Programme or survey: programme.
* Recall period/periodicity: 2 years
* BreastScreen Aotearora (BSA) has offered government funded biennial mammography screening for all New Zealand women aged 50-64 years , since 1999. In July 2004, the target group was extended to include women aged 45-49 years and 65-69 years.
* In the June 2007 monitoring report, coverage figures changed to include the 64-69 year age extension as 2 full years had elapsed from the introduction of the age extension. Coverage for 45-49 years is not included in this figure because there is no national target for screening coverage for this age groups based on robust trial benchmarks.
* The latest available coverage data is for June 2007. BSA coverage for the 2-year period, up to the end of June 2007, for women aged 50-69 years is 61.2%.
* Coverage is a population-based measure of the percentage of women in the target age-range (50-69 years) who had a screening mammogram in the programme, during the specified time period.
* The BSA recall period is 24 months. Therefore, the figure above includes all women screened between 1 July 2005 and 30 June 2007. Both first screening events (women newly enrolled in the programme) and subsequent screening events (women already enrolled) are included.
* Coverage is expressed as a proportion. The denominator used is the usually resident New Zealand population of women aged 50-69 years, from the 2001 Census projections, provided by Statistics New Zealand.
* The data comes from BSA published Independent monitoring reports and represents women screened in BSA, out of those eligible from the relevant census. These figures do not include women screened privately or high-risk women screened annually outside of BSA (in diagnostic services) The denominator differs from other countries, e.g. the UK, in that the denominator for the latter is women identified via a population register.
* Source: BreastScreen Aotearoa Independent Monitoring Reports, National Screening Unit, Ministry of Health, New Zealand.
* The 2006/2007 New Zealand Health Survey includes a question on mammography screening. The results are due to be published in June 2008. However, BSA’s data sources are considered a more accurate record of screening events than the national survey for calculating total population coverage.
* Usually National Health Survey shows a greater screening coverage than the BSA programme figures above, because the survey includes women who have screening mammography outside of the national screening programme.

Norway

Norwegian Breast Cancer Screening Programme.
* Population: National, full population.
* Age variation: 50-69.
* Programme or survey: programme.
* Recall period/periodicity: 2 years.
* Comments: Nationwide since February 2004, 2 views, 2-year screening interval. Quality assurance manual based on EU guidelines.

Poland

2004 data: Central Statistical Office. Health Interview Survey conducted by CSO.
* Instrument comprises of following questions:
1. Have you ever had a mammography? Yes; No.
2. When was the last time you had a mammography? Give the number of years (if during the last year – write 0).

Portugal

Programa de rastreio cancro da mama da regiao centro (Liga portuguesa contra o cancro).
* Population:Regional, generalisable.
* Age variation: 50-69.
* Programme or survey: programme.
* Recall period/periodicity: 2 years.
* Comments: Data refers to full coverage of Central region only (28 municipalities). North has screening in two districts and South in three and two partial screenings. Population programmes in accordance with the European Guidelines for Quality Assurance Mammography Screening.

Slovak Republic

General Health Insurance Company.
* Data represents mammography screening among women insured by the General Health Insurance Company (60 to 68 % of the Slovak population is insured by the General Health Insurance Company).

Spain

* Data not available.

Sweden

Swedish Regional Cancer Screening Programme.
* Population:Regional.
* Age variation: 50-74.
* Programme or survey: programme.
* Recall period/periodicity:2 years.
* Comments: Regional in the county of Östergötland. Programme for women ages 50-74. Some county councils have programs starting at 40.

Switzerland

* Data not available at the national level.

Turkey

* Data not available.

United Kingdom

Department of Health, Welsh Assembly Government, Office for National Statistics
NHS Breast Screening Programme .
* Population: National, full population.
* Age variation: 50-64.
* Programme or survey: programme.
* Recall period/periodicity: 3 years.
*

Data for England only.
* 2007 – data is for UK. Backdated UK figures have been supplied from 1999.

United States

National Center for Health Statistics: 2000, 2003, 2005 National Health Interview Survey Sample Adult Data file (unpublished data). For further information, please visit the HIS website: http://www.cdc.gov/nchs/nhis.htm.
Coverage: National, representative sample: Civilian non-institutionalized U.S. population, females aged 50-69 years.
Periodicity: Recall periodicity: 2 years (Data collected 2000, 2003, 2005).
Deviation from the definition: Data does not match OECD definition.
* Numerator: Number of women aged 50-69 years old reporting having received a mammogram two years ago or less.
* Denominator: Denominator excludes respondents (females aged 50-69 years old) who reported “Refused”, “Not ascertained”, or “Don’t know” to the question “Have you ever had a mammogram?”.
* Deviation from the calculation method: Calculation methods match OECD definition. The measure is percent of women 50-69 years who have had a mammography within the preceding 2 years.
* Break in time series: No breaks in time series.


Source OECD HEALTH DATA 2008, December 08	Last update: 10/23/2008