Aim: Providing an overview of evaluation results from organised screening-programs, this report informs quality management of new programs and supports benchmarking efforts.
Method: Internet search for evaluation reports of organised screening programs published in German or English. Evaluation results were extracted, analysed and compared.
Results: Evaluation reports from seven countries were identified. Germany, Australia, Ireland, Italy, Canada, New Zealand, United Kingdom are presented in detail. All programs are successful in detecting small invasive cancers. Aimed for participation rates are not met by programs – except for Ireland and the United Kingdom.
Program specific process results show considerable variation. Recall rates – influencing detection and false positives – vary widely. Tumors e.g. in the UK are more often operated on without prior verification of diagnosis than in Germany. Time needed for diagnosis of screening-mammography and waiting time until recall appointment differ. These are shorter e. g. in Germany than in New Zealand. Information for invited women to enable the decision against or for taking part in screening is not given independently of program institutions (funders, service providers, management). Program evaluation is only rarely conducted independently of program institutions. Both fields require action.
Conclusion: As a public health measure mammography screening addresses healthy women. Hoped for benefits and possible harms have to be balanced based on available evidence to justify program funding from the public purse. Increasingly long standing screening programs provide more and more data for evaluation and research. Younger programs only start to establish data collection infrastructures. Those data play a key role in the evaluation of screening.