Mammography screening (Breast cancer screening), survey data and programme data (Source OECD HEALTH DATA 2010, June)

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

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

Mammography rates.

Numerator: Number of women age 50-69 reporting having received a bilateral mammography according to the specific screening frequency recommended in each country.

Denominator: Number of women age 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	Germany	Netherlands	Austria	Korea
Belgium	Hungary	New Zealand	Canada	Mexico
Canada	Iceland	Norway	Denmark	Netherlands
Chile	Ireland	Portugal	France	New Zealand
Czech Republic	Israel	Slovak Republic	Greece	Poland
Estonia	Italy	Turkey	Italy	United States
Finland	Korea	United Kingdom	Japan
France	Luxembourg

Australia

Programme data
Australian Institute of Health and Welfare 2009. BreastScreen Australia monitoring report 2005-2006. AIHW Cat. No. CAN44. Canberra: AIHW (and previous issues). Also at www.aihw.gov.au.
* National coverage.
* Numerator: Number of women aged 50-69 having received a mammogram through national screening programme over a 24-month period.
* Denominator: Average number of female residents aged 50-69 between the reporting year and the previous year.
* Screening programme: mammography every two years for women aged 50-69.

Austria

Survey data
Austrian Health Interview Survey 2006/2007.
* National representative sample.
* Numerator: Number of women aged 50-69 reporting having received a mammogram during the past 12 months.
* Denominator: Number of women aged 50- 69 answering the survey.
* The survey will be repeated every 5 years.

Belgium

Programme data
Programme de Dépistage du Cancer du Sein. Periods 2001-2002, 2003-2004 and 2005-2006. Report number 6 from the Agence Intermutualiste. January 2009 (http://www.nic-ima.be/).
* National coverage.
* Numerator: Number of women aged 50-69 having received a mammogram through or outside the organised screening programme during the past two years.
* Denominator: Number of female residents aged 50-69 in the past two years.
* Screening programme: mammography every two years for women aged 50-69. Prior to 2003, the target age was 50-70.

Canada

Survey Data
Statistics Canada, National Population Health Survey, 1996/97 and 1998-99 and Canadian Community Health Survey, 2000/01, 2003 and 2005.
* National representative sample.
* Numerator: Number of women aged 50-69 reporting having received routine screening mammogram or having received mammogram for other reasons within the last two years. 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%

* Denominator: Number of women aged 50-69 answering the survey.

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).
* National coverage.
* Numerator: Number of women aged 50-69 having received a mammogram through the organised screening programme during the past two years.
* Denominator: Number of asymptomatic women aged 50-69 with no prior diagnosis of breast cancer, in the past two years.
* Screening programme: mammography every one or two years for women aged 50-69 or 40-49, depending on the jurisdictions.

Chile

Programme data
Ministry of Health, Department of Statistics and Health Information http://deis.minsal.cl/index.asp
* Data are collected by the team in charge of the programme at the local levels and consolidated by the national team.
* Data refer only to those covered by the public health insurance scheme, accounting for 73.5% of total population. The rest of the population is covered by private health insurances or "Defense Health System” (members of the Army, Navy, Police, Air Force and their direct family).
* Numerator: Number of women aged 50-54 who received a mammogram through or outside the organised screening programme in the past two years.
* Denominator: Number of women aged 50-54 who were beneficiaries of the public health system as of June 30th in the reporting year.
* Deviation: age group.
* Screening recommendation: mammography every two years for women aged 50-54. Prior to 2009, for women aged 50.

Czech Republic

Programme data
Breast Cancer Screening Database (Institute of Biostatistics and Analyses, Faculty of Medicine and the Faculty of Science, Masaryk University, www.iba.muni.cz)
* National coverage.
* Data cover all examinations performed at the accredited screening centres participating in the National breast cancer screening programme. For the first quarter of 2004, national data is estimated based on records from one centre.
* Numerator: Number of women aged 50-69 having received a mammogram through the organised breast cancer screening programme during the past two years.
* Denominator: Number of female residents aged 50-69 in the past two years.
* Screening programme: mammography every two years for women aged 45 and over.

Denmark

Survey data
Danish Health Interview Surveys, 2005.
* National representative sample.
* Numerator: Number of women aged 16 and over reporting having received a mammogram through or outside organised breast cancer screening programme during the past three years.
* Denominator: Number of women aged 16 and over answering the survey question.
* Deviation: age group.
* Screening programme: mammography every two years for women aged 50-69. The programme has not been rolled out nationwide.

Estonia

Programme data
Estonian Health Insurance Fund (www.haigekassa.ee) database
National Institute for Health Development, Non-infectious diseases prevention department (http://www.tai.ee/?id=2439 )
* National coverage.
* Numerator: Number of women aged 50-65 who participated in the national screening programme in a 12-month period.
* Denominator: Number of women aged 50-65 who were invited to the screening programme in a 12-month period. Invitations are not sent to women who have diagnosis of breast cancer, who participated in screening or had mammography in the previous year, or who do not have valid
health insurance (~10%), or whose address in the population register is incomplete, and the denominator excludes these women.
* Deviation: age group.
*

Data refer to women aged 45-59 for 2002-2005, women aged 50-59 for 2006 and 2007 and women aged 50-65 from 2008.
Calculation method: The proportion of women in the target population participating in the national screening programme a 12-month period.
* Screening programme: mammography every two years for women aged 50-65 since 2007. Before 2007 invitation principles were not directly set.

Finland

Programme data
National screening programme.
* National coverage.
* Numerator: Number of women aged 50-69 who were invited and received a mammogram through the organised breast cancer screening programme during the year.
* Denominator: Number of women aged 50-69 who received issued personal invitations to undergo organised breast cancer screening during the year. Personal invitations are sent to all women who belong to the target age group.
*

target age is 50-69 but prior to 2007, it was 50-59.
* Screening programme: mammography every two years for women aged 50-69. Prior to 2007, for women aged 50-59 but some municipalities also invited women aged 60-64 or 65-69.

France

Survey data
Survey on health and social protection, IRDES (http://www.irdes.fr).
* National representative sample.
* Numerator: Number of women aged 50-74 reporting having received a mammogram during the past two years.
* Denominator: Number of women aged 50-74 answering survey questions.
* Deviation: age group.
* There exists a bias linked to the fact people tend to report the date of the latest screening as more recent than it actually was. * Screening programme: mammography every two years for women aged 50-74.

Programme data
Institut National du Cancer
* National coverage.
* Numerator: Number of women aged 50-74 having received a mammogram through the organised screening programme during the past two years.
* Denominator: Number of women aged 50-74 based on population census (INSEE Data) in the reporting year.
* Screening recommendation: mammography every two years for women aged 50-74.

Germany

Programme data
Kooperationsgemeinschaft Mammographie, Mammographie-Screening-Program.
http://www.kooperationsgemeinschaft-mammographie.de
* Age variation: 50-69 years old.
* Women are invited to screening based on the inhabitants’ registries. Each woman should be invited every two years. The examination and assessment is free for the women.
* In the years 2005 to 2007 2.68 million women aged between 50 and 69 years were asked to undergo a mammogram examination. All in all 10.4 million women were entitled to (79 of 94 reference regions). This corresponds to an attendance rate of about 54%.
* Comments: 2002 the German parliament had decided to introduce service screening in Germany for women aged 50–69. The programme strictly follows the ‘European Guidelines for Quality Assurance in Mammography Screening and Diagnosis’. The program is put into reality by an institution called ‘Kooperationsgemeinschaft Mammographie’. The ‘Kooperationsgemeinschaft Mammographie’ is responsible for additional regulations, for interpretation of the regulations, for all certifications and recertifications. It is supported by 6 Reference Centers, which are responsible to offer training courses and offer possibilities for secondment to technologists and doctors involved in the program. Germany is split up into 94 reference regions, and it has been decided that one or two doctors have to be responsible for the program in each of the regions. The responsibilities include medical and organizational issues for the whole program in that area.
* Screening programme: mammography every two years for women aged 50-69.

Greece

Survey data
“Hellas Health I” and “Hellas Health II” surveys
Center for Health Services Research, Medical School, University of Athens
*National representative sample.
* The percentage of women aged 50-69 years reporting having received a mammogram during the past three years.
* Screening recommendations: every one or two years for women aged 40 and over.

Hungary

Programme data
Hungarian National Health Insurance Fund (OEP). www.oep.hu (in Hungarian).
* National coverage.
* Numerator: Number of women aged 45-65 who received a mammogram through the organised breast cancer screening programme during the past two years.
* Denominator: Number of women aged 45-65 who were invited to the organised breast cancer screening programme during the past two years.
* Deviation: age group.
* Screening programme: every two years for women aged 45-65. Organised screenings for breast cancer started in January 2002 in Hungary.

Iceland

Programme data
Cancer Detection Centre of the Icelandic Cancer Society, Ministry of Health.
* National coverage.
* Numerator: Number of women aged 40-69 who received a mammogram through or outside the organised breast cancer screening programme during the past two years.
* Denominator: Number women aged 40-69 who were invited to the organised breast cancer screening programme during the past two years. The denominator excludes women with prior diagnosis of breast cancer as these women belong to special follow-up groups with some closer intervals than the unaffected women and they are not part of the target population that get personal invitation every other year.
* Deviation: age group.
* Screening programme: mammography every two years for women aged 40-69.

Ireland

Programme data
BreastCheck.
* National coverage.
* Numerator: Number of women aged 50-64 who received an offer of screening and received a mammogram through the organised screening programme during the past two years.
* Denominator: Number of women aged 50-64 who have received an offer of screening during the past two years.
The denominator includes women who have opted not to partake in the programme and also includes those who do not need/decline to participate in the screening because of prior diagnosis of breast cancer, and regular follow-up.
* The numbers presented refer to "Known Target Population" uptake which includes all women of screening age that are known to the programme including women who are suspended, excluded of have opted not to consent to partake in the programme. Data compiled from Dept Social welfare, General medical services, Health Insurance providers, self-register, and other estimated to capture 98% target population. * Deviation: age group.
* Screening programme: mammography every two years for women aged 50-64. BreastCheck has been a nationwide screening programme since 2007.

Israel

Programme data
National screening program of the Ministry of Health
* Coverage close to 100% for screening tests and over 90% for diagnostic tests.
* Numerator: Number of women aged 50-74 having received a mammogram through or outside the screening programme during the year.
* Denominator: Number of female residents aged 50-74 in the reporting year.
* Data refer to the average for the past two years.
* Deviation: age group.
* Screening programme: mammography every two years for women aged 50-74. Women at high risk are offered annual mammography from 40 and women at very high risk (BRCA carriers) are offered annual MRI.

Italy

Survey data
Behavioural Risk Factor Surveillance System PASSI
http://www.iss.it/binary/publ/cont/0931.pdf
* National representative sample covering 20 out of 21 Italian regions..
* Numerator: Number of women aged 50-69 reporting having received a mammogram during the past two years.
* Denominator: Number of women aged 50-69 answering the survey questions.
* Screening programme: mammography every two years for women aged 50-69.

Programme data
Ministry of Health - National Centre for Screening Monitoring.
http://www.osservatorionazionalescreening.it/eng/about_us.htm.
* Regional coverage. As of 2008, 67.5% of the women aged 50-69 were invited to the breast cancer screening programmes. The coverage was 62.3% for 2007.
* Numerator: Number of women aged 50-69 who received a mammogram through the organised breast cancer screening programme during the past two years.
* Denominator: Number of women aged 50-69 who were invited to the organised breast cancer screening programmes during the past two year. The denominator does not always exclude those who do not need/decline to participate in the screening because of the prior diagnosis of breast cancer.
* Screening programme: mammography every two years for women aged 50-69.

Japan

Survey data
Ministry of Health, Labour and Welfare, Comprehensive Survey of Living Conditions.
* National representative sample.
* Numerator: Number of women aged 50-69 reporting having received a breast cancer screening during the year. The numerator includes those women with breast cancer screening other than mammography (e.g., Clinical Breast Examination (CBE) and ultrasonography).
* Denominator: Number of women aged 50-69 answering the survey question.
* The survey has been conducted every three years since 2001.
* Screening recommendation: breast cancer screening (including screening other than mammography) every two years for women aged 40 and over.

Korea

Survey data
Korea National Cancer Screening Survey, National Cancer Center
(Reference: Ministry for Health, Welfare and Family Affairs, National Cancer Center. Cancer Facts & Figures 2009 in the Republic of Korea. )
* National representative sample.
* Numerator: Number of women aged 50-69 reporting having received a mammogram during the past two years.
* Denominator: Number of women aged 50-69 answering the survey.
* Screening programme: mammography every two years for women aged 40 and over.

Programme data
National Health Insurance Corporation (NHIC)
* National coverage.
* Numerator: Number of women aged 50-69 who were invited to breast cancer screening programme and had a mammography through the organised breast cancer screening programme during the year.
* Denominator: Number of women aged 50-69 who were invited to a mammography organised by breast cancer screening programme during the year.
*

Prior to 2003 and between 2005 and 2007 data refer to women aged 50 and over. 2004 data refers to women aged 40 and over.
* Screening programme: mammography every two years for women aged 40 and over.

Luxembourg

Programme data
Ministère de la Santé and the National Health Insurance (CNS)
* National coverage. Those covered by health insurance.
* Numerator: Number of female residents aged 50-69 having received a mammography through the organised screening programme during the past two years. (Screening is also offered to non-resident females covered by health insurance who commute from neighbouring countries.)
* Denominator: Number of female residents aged 50-69 as of January 1st of the reporting year.
*

Target age group is 50-69 since 2001 but it was 50-64 before.
* Screening programme: mammography every two years for women aged 50-69.

Mexico

Survey data
National Survey on Health and Nutrition 2006.
Ministry of Health. National Institute of Public Health.
* Results are from 48,000 households. Data included 32 states. The survey is representative at national and state level.
* 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
Integrated System of Social Surveys (POLS)
* National representative sample.
* Numerator: Number of women aged 50-69 reporting having received a mammogram during the past two years.
* Denominator: Number of women aged 50-69 answering the survey question. The denominator excludes those who answered 'don't know'.
*

2000 data refers to women aged 50-69 who ever had a mammography.
* Screening programme: mammography every two years for women aged 50-75.

Programme data
National Evaluation Team for Breast cancer screening, administration of the breast cancer screening organisations
* National coverage.
* Numerator: Number of women aged 50-69 who received a mammogram through the organised breast cancer screening programme during the specific round. The numerator includes the women who were invited to the screening in the reporting year and had a mammogram just before the reporting year or a few months after the end of the reporting year.
* Denominator: Number of women aged 50-69 who were invited to the organised breast cancer screening during the reporting year. The denominator does not include women not in the Population Registration. Women who declared not wanting an invitation anymore (definite refusers) and women with an interval or screening carcinoma generally do not receive an invitation for subsequent screens, so they are not included in the denominator.
* Screening programme: mammography every two years for women aged 50-75.

New Zealand

Survey data
Independent Monitoring Reports, National Screening Unit, Ministry of Health, New Zealand.
2007 New Zealand Health Survey, Ministry of Health, New Zealand
* National representative sample.
* Numerator: Number of women aged 50-69 reporting having received a mammogram within the past two years.
* Denominator: Number of women aged 50-69 answering the survey question.
* Usually National Health Survey shows a greater screening coverage than the BreastScreen Aotearoa (BSA) programme figures because the survey includes women who have screening mammography outside the national screening programme. BSA’s data sources are considered a more accurate record of screening events than the national survey for calculating total population coverage.
* Screening programme: mammography every two years for women aged 45-69. Between 1999 and July 2004, for women aged 50-64.

Programme data
BreastScreen Aotearoa (BSA) a screening programme of the National Screening Unit, a separate unit of the Ministry of Health.
* National coverage.
* Numerator: Number of women aged 50-69 who underwent mammography screening through organised screening programme within the public health system during the two year period to the annual reporting period ending on 31 December. The numerator excludes those screened privately such as opportunistic screenings and high-risk women in the age group screened annually outside the programme (in diagnostic services). Both women with first screening events (women newly enrolled in the programme) and those with subsequent screening events (women already enrolled) are included.
* Denominator: Number of women aged 50-69 who were alive and resident in New Zealand in the two year period to the reporting period ending on 31 December. The denominator does not exclude those who do not need/decline to participate in the screening because of the prior diagnosis of breast cancer.
*

From 2006, data refer to women aged 50-69 years but 2003-2005 data refer to women aged 50-64.
* Screening programme: mammography every two years for women aged 45-69. Between 1999 and July 2004, for women aged 50-64.

Norway

Programme data
Norwegian Breast Cancer Screening Programme.
* National coverage.
* Numerator: Number of women aged 50-69 who received a mammography through the organised breast cancer screening programme during the past two years.
* Denominator: Number of women aged 50-69 who were invited to the organised breast cancer screening programme during the past two years. The denominator excludes those who do not need/decline to participate in the screening because of the prior diagnosis of breast cancer
* Screening programme: mammography every two years for women aged 50-69.

Poland

Survey data
Central Statistical Office. Health Interview Survey conducted by CSO.
* National representative sample.
* Numerator: Number of women aged 50-69 reporting having received the last mammography in the past two years.
* Denominator: Number of women aged 50-69 answering the survey question.
* Screening Programme: mammography every two years for women aged 50-69.

Portugal

Programme data
Portuguese Ministry of Health – Health High Commissioner / Cancer National Coordination ; data provided from the Regional Health Administrations and Contracting Screening Institutions
* Regional coverage. The National Programme was rolled out in 2005 and the rollout was complete in 2009. Screening is initiated in 69% of the counties.
* Deviation: age group is 45-69 except in one of the regions - Algarve (50-69).
* Screening programme: mammography every two years for women aged 50-69.

Slovak Republic

Programme data
General Health Insurance Company (GHIC)
* Data refer to 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).

Slovenia

* Data not available.
* Screening recommendation: mammography every two years for women aged 50-69.

Spain

* Data not available.

Sweden

* Data not available.
* Screening programme: mammography every two years for women aged 40-74.

Switzerland

* Data not available at the national level.
* Screening programme: mammography every two years for women aged 50-70.

Turkey

Programme data
Department of Cancer Control, Ministry of Health
* Regional coverage. As of 2009, 122 KETEM (Early Diagnosis, Screening and Training Center for Cancer) centers were established in the country and 80 of them were operational, and it is aimed to establish 280 KETEMs by the end of 2015.
* The sum of the percentage of women aged 50-69 who received a mammogram through the organised screening programme during the reporting year and the percentage of women aged 35-69 who received a mammogram outside the organised screening programme during the reporting year.
*

Prior to 2008, women who received a mammogram through the organised screening programme referred to women aged 35-69 and from 2009 data refer to women aged 50-69.
* Screening programme: mammography every two years for women aged 50-69.

United Kingdom

Programme data
NHS Information Centre for health and social care, Breast Test Wales, Information Services Division, NHS in Scotland, Department for Health, Social Security and Public Safety, Northern Ireland NHS Breast Screening Programme .
NHS Breast Screening Programme.
* National coverage.
* Numerator: Number of women aged 50-64 in England, Scotland and Northern Ireland and 53-64 in Wales who received a mammogram through or outside the organised screening programme during the past three years.
* Denominator: Number of women aged 50-64 in England, Scotland and Northern Ireland and 53-64 in Wales who were invited for a mammography organised by screening programmes during the past three years.
* Data are based on ‘uptake’ rates not ‘coverage’ as uptake rates are a better measure of overall performance acceptance. Coverage rates are affected by programme slippage (the number of eligible women who have not been invited), acceptance (the number of women who do not attend), and re-booking (around 20% of women invited re-book their appointment for a later date, often falling outside the three-year period).
* Data are the weighted average of four countries in the United Kingdom. Data for all four countries are based on KC62 form.
* England data: http://www.ic.nhs.uk/statistics-and-data-collections/screening/breast-cancer/breast-screening-programme-england-2004-05 and http://www.ic.nhs.uk/webfiles/publications/breast_screening/Breast_Screening_Programme_Tables_2008_09.xls
* Wales data: http://www.screeningservices.org.uk/btw/reports/reports.asp
* Scotland data: http://www.isdscotland.org/isd/servlet/FileBuffer?namedFile=Attendance.xls&pContentDispositionType=inline
* Northern Ireland data: http://www.dhsspsni.gov.uk/index/phealth/public_health-factsandfigures.htm (2006-2008), www.cancerscreening.hscni.net/statistics/bpstatistics.html#P-4_0 (2000-2004), wwww.dhsspsni.gov.uk/cmo_2001.pdf (1996-2000)
* Screening programme: mammography every two years for women aged 50-70. Women over 70 can also request invitation in Northern Ireland, Scotland and Wales.

United States

Survey data
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 of the U.S. Civilian Non-Institutionalised Population, females aged 50-69 years.
* Numerator: Number of women aged 50-69 reporting having received a mammogram one year ago or less.
* Denominator: The denominator excludes respondents (females aged 50-69) 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.
* Screening recommendation: mammography every one or two years for women in target age groups. The lowest age for the target group varies from around 40 to 50.


Source OECD HEALTH DATA 2010, June	Last update: 06/21/2010