Presence, characteristics and equity of access to breast cancer screening programmes in 27 European countries in 2010 and 2014. Results from an international survey

Abstract

The European Union Council Recommendation of 2 December 2003 on cancer screening suggests the implementation of organised, population-based breast cancer screening programmes based on mammography every other year for women aged 50 to 69years, ensuring equal access to screening, taking into account potential needs for targeting particular socioeconomic groups. A European survey on coverage and participation, and key organisational and policy characteristics of the programmes, targeting years 2010 and 2014, was undertaken in 2014. Overall, 27 countries contributed to this survey, 26 of the 28 European Union member states (92.9%) plus Norway. In 2014, 25 countries reported an ongoing population-based programme, one country reported a pilot programme and another was planning a pilot. In eight countries, the target age range was broader than that proposed by the Council Recommendation, and in three countries the full range was not covered. Fifteen countries reported not reaching some vulnerable populations, such as immigrants, prisoners and people without health insurance, while 22 reported that participation was periodically monitored by socioeconomic variables (e.g. age and territory). Organised, population-based breast cancer screening programmes based on routine mammograms are in place in most EU member states. However, there are still differences in the way screening programmes are implemented, and participation by vulnerable populations should be encouraged.

Experiences and perceptions about undergoing mammographic screening: a qualitative study involving women from a county in Sweden

“…All these actors are part of the society and existing in women’s daily lives, hence may exert implicit or explicit pressure to attend. The national attendance rate of approximately 80% in Sweden (Deandrea et al, 2016; National Board of Health and Welfare, 2014b) may partly be explained by these circumstances. Another Swedish qualitative study focusing on women attending mammographic screening (Willis, 2008) used purposive sampling (Polit & Beck, 2010) and had a more heterogenic sample.…”

“…For an organized population-based screening programme to be offered, it should be (among other things) cost-effective, which requires a high-attendance rate (National Board of Health and Welfare, 2014a; Törnberg, Lidbrink, & Henriksson, 2014). In Sweden, mammographic screening is offered to all female residents between the ages of 40 and 74 (National Board of Health and Welfare, 2014b); the approximately 80% national attendance rate (Deandrea et al, 2016; National Board of Health and Welfare, 2014b) is aligned with the national recommendation for an attendance rate of at least 80% (Official Reports of the Swedish Government, 2009). Nevertheless, the attendance rates in the counties vary from 71% to 90% (Swedish Breast Cancer Association, 2015); differences have also been found among areas in cities, with attendance rates ranging from 37% to 82% (Zackrisson, Lindström, Moghaddassi, Andersson, & Janzon, 2007).…”

Systematic review on women's values and preferences concerning breast cancer screening and diagnostic services

“…Breast cancer is the most common cancer in women and one of the leading causes of all cancer deaths both in Europe and worldwide . Breast cancer screening with mammography, the only population‐based method for the early detection of breast cancer currently used, has been shown to reduce breast cancer mortality in women aged 50 to 74 years and is widely implemented in most European countries . However, mammography screening is also associated with potential important undesirable effects, including overdiagnosis, and hence overtreatment, and false‐positive mammography results .…”

Factors affecting access to treatment of early breast cancer: Case studies from Brazil, Canada, Italy, Spain and UK: Implications for future research, policy and practice

“…Across the EU, a number of socioeconomic and cultural factors were found to account for the disparity in access to breast cancer screening and treatment (Deandrea et al 2016). There is evidence that women of lower socioeconomic status participate less in cancer screening programmes than women of higher socioeconomic status (Deandrea et al 2016), one interviewee suggesting this might be because of lack of awareness, stigma, cultural factors and language barriers (not understanding the invitation) (INT17).…”