APH 2006, 64, 71-80:

Evaluation of the first round of the national breast cancer screening programme in Flanders, Belgium.

K. De Gauquier, A. Remacle, V. Fabri, R. Mertens

Keywords: Belgium, mammography, mass screening, programme evaluation

Introduction: In June 2001, a breast cancer screening programme was started in Flanders for all women aged 50-69 years. Until that date, screening was opportunistic and devoid of quality control. In this paper, the evolution during the first two-year round is compared with the situation before the programme.

Methods: The study population comprised all women aged 50-69 years living in Flanders in the period 2000-2003. The data source was the reimbursement claims database of all social insured of the country, for mammograms, breast ultrasounds and magnetic resonance imaging.

Results: In the 2002-2003 period, the participation rate by screening mammography was 32.7%. When adding the participation to the still existing opportunistic screening (21.7%), the percentage of women who underwent a mammography amounts to 54.3% of the study population, as compared to 40.5% in the preceding two years. The programme has also reduced inequities between age groups and socio-economic categories: almost all women participate in an equal manner. In 2003, as many as 77.3% of the diagnostic mammograms and 6.3% of the screening mammograms were followed within 90 days by additional imaging.

Conclusion: This organised screening programme already reached a substantial proportion of the target group during its launch period. It also managed to attract women of all ages and of all socio-economic
backgrounds. Yet, there remains a long way to go before reaching at least 70% of the target population. The other big challenge is to convince physicians to replace the diagnostic mammography and the ultrasound by the quality-controlled screening mammography.