Breast cancer screening programmes in 22 countries: current policies, administration and guidelines

The finding that mammography with or without clinical breast examination can reduce breast cancer mortality by 25-30% has prompted several countries to introduce routine screening on a population basis. The International Breast Cancer Screening Network (IBSN) conducted surveys in 1990 and 1995 to yield international data on the policies funding and administration of national regional or pilot population-based screening programs. Comparison of the results of the two surveys revealed several changes from 1990 to 1995. The number of countries (primarily European) that have established or plan to launch breast cancer screening programs increased from 9 to 22. There has been a trend toward raising the lower age limit for mammography screening from 40 to 50 years with a 2-year interval between screenings. Also noted was more widespread use of the clinical breast examination and breast self-examination as additional detection methods. Countries with centralized systems for policy funding and administration were more likely to have achieved complete population coverage than those with decentralized systems. The IBSN is shifting its focus from generating an international database to developing methodologies for the evaluation of mammography screening outcomes.