Breast cancer screening in Europe

What is the point of the situation in breast cancer screening in Europe? Are there official screening recommendations in every country? Are there financial incentives related to this screening? Are we giving the correct information about harms and benefits of this screening to European women?

Rosália Páscoa and Emmily Schaubroeck collected these data on behalf of EUROPREV network.

Until now, we have data from seventeen countries, but we will continue to update this information set.

You may consult detailed information about each country by following the hyperlink:

Belgium

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link: Flemish Region and Walloon Region

Role of the general practitioners/family physicians in breast cancer screening:
General practitioners/family physicians have a more passive role, only advise women on breast cancer screening if patients ask (otherwise women are invited by the breast cancer screening program) and are not directly involved in the prescription of mammography.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? No

Croatia

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? Yes

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? No

Czech Republic

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: ≥ 45 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Role of the general practitioners/family physicians in breast cancer screening:
General practitioners/family physicians have an active role, they are the ones who invite women to the screening and who prescribe the mammography.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? No

Denmark

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? Yes

France

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-74 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? Yes

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? Yes

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? Yes

Germany

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? Yes

Ireland

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Role of the general practitioners/family physicians in breast cancer screening: General practitioners/family physicians have a more passive role, only advise women on breast cancer screening if patients ask (otherwise women are invited by the breast cancer screening program) and are not directly involved in the prescription of mammography.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? No

Israel

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-74 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link(page 136).

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? Yes

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? Yes

Italy

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years (Tuscany region: 45-74 years)

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? No

Poland

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Role of the general practitioners/family physicians in breast cancer screening: General practitioners/family physicians have a more passive role, only advise women on breast cancer screening if patients ask (otherwise women are invited by the breast cancer screening program) and are not directly involved in the prescription of mammography.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? No

Portugal

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? Yes

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? Yes

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? No

Romania

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: No screening recommendations

Screening method: No screening recommendations

Screening frequency: No screening recommendations

Recommendations available in this link: No screening recommendations

Role of the general practitioners/family physicians in breast cancer screening: No screening recommendations

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No screening recommendations

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No screening recommendations

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? No screening recommendations

Slovenia

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? No

Spain

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link. Leaflet available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? Yes

The Netherlands

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-75 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? Yes

Ukraine

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-69 years

Screening method: mammography

Screening frequency: every 2 years

Recommendations available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? No

United Kingdom

Summary of recommendations for women at average risk (without a personal or family history of breast or ovary cancer):

Target age group: 50-71 years

Screening method: mammography

Screening frequency: every 3 years

Recommendations available in this link.

Financial incentives to perform breast cancer screening (for example, is it involved as an indicator in a pay per performance system)? No

Is breast cancer screening associated with any kind of quality indicator to assess general practitioners/family physicians’ work (or primary health care team’s work)? No

When women are invited to undergo breast cancer screening, do they receive information about possible harms related to this screening (e.g., overdiagnosis, false positives)? Yes

European Network for Prevention and Health Promotion in Family Medicine and General Practice

Breast cancer screening in Europe

Belgium

Croatia

Czech Republic

Denmark

France

Germany

Ireland

Israel

Italy

Poland

Portugal

Romania

Slovenia

Spain

The Netherlands

Ukraine

United Kingdom

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