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
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.