Implementation of the German Mammography Screening Program (German MSP) and First Results for Initial Examinations, 2005-2009Malek D. · Kääb-Sanyal V.
Kooperationsgemeinschaft Mammographie, Berlin, Germany
Dr. Daniela Malek
10623 Berlin, Germany
Do you have an account?
Background: The German Mammography Screening Program (German MSP) is population-based and intended for women aged 50-69 years (approximately 10.5 million). The program started in 2005 and was implemented within 5 years. This article describes the implementation, structure, and screening process, and presents the results of initial examinations for the prevalence phase. Methods: Data were collected annually from invitation centers (invitation, attendance), screening units (performance, outcomes), and cancer registries (incidence). Results: In 2009, 92% of all annually eligible women were invited; 50% of the annually eligible population participated. The total cancer detection rate in the period of 2005-2009 was 8.1/1,000; the corresponding recall rate was 5.9%. 19.6% of detected cancers were ductal carcinoma in situ; 76.7% of invasive cancers were ≤ 20 mm in size, 30.2% were ≤ 10 mm, and 75.3% were node-negative. During the implementation period, incidence increased by 37 and 56% in the old and new federal states, respectively. Incidence rates decreased following the prevalence phase. Conclusion: The German MSP was successfully implemented. The results of the prevalence phase meet the target values of the European guidelines. Proper functioning of the program is also verified by its effects on breast cancer incidence. To draw reliable conclusions regarding the long-term effects of the program, results from the routine screening rounds have to be awaited.
© 2016 S. Karger GmbH, Freiburg
- Giordano L, von Karsa L, Tomatis M, Majek O, de Wolf C, Lancucki L, Hofvind S, Nystrom L, Segnan N, Ponti A, Van Hal G, Martens P, Danes J, von Euler-Chelpin M, Aasmaa A, Anttila A, Becker N, Pentek Z, Budai A, Madai S, Fitzpatrick P, Mooney T, Zappa M, Ventura L, Scharpantgen A, Seroczynski P, Morais A, Rodrigues V, Bento MJ, Gomes de Carvalho J, Natal C, Prieto M, Sanchez-Contador Escudero C, Zubizarreta Alberti R, Fernandez Llanes SB, Ascunce N, Ederra Sanza M, Sarriugarte Irigoien G, Salas Trejo D, Ibanez Cabanell J, Wiege M, Ohlsson G, Tornberg S, Korzeniewska M, Fracheboud J, Patnick JJ, Ducarroz S, Suonio E: Mammographic screening programmes in Europe: organization, coverage and participation. J Med Screen 2012;19(suppl 1):72-82.
- Marmot MG, Altman DG, Cameron DA, Dewar JA, Thompson SG, Wilcox M: The benefits and harms of breast cancer screening: an independent review. Br J Cancer 2013;108:2205-2240.
- Pace LE, Keating NL: A systematic assessment of benefits and risks to guide breast cancer screening decisions. JAMA 2014;311:1327-1335.
Perry N, Broeders M, de Wolf C, Törnberg S: European Guidelines for Quality Assurance in Mammography Screening, 3rd ed. Luxembourg, Office for Official Publications of the European Communities, 2001.
Perry N, Broeders M, de Wolf C, Törnberg S, Holland R, von Karsa L, Puthaar E: European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis, 4th ed. Luxembourg, Office for Official Publications of the European Communities, 2006.
Evaluationsbericht 2011. Zusammenfassung der Ergebnisse des Mammographie-Screening-Programms in Deutschland. Berlin, Kooperationsgemeinschaft Mammographie, 2014.
Krebs in Deutschland 2005/2006. Häufigkeiten und Trends. 7. Auflage. Berlin, Robert-Koch-Institut (Hrsg.) und die Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (Hrsg.), 2010.
- Zahl PH, Strand BH, Maehlen J: Incidence of breast cancer in Norway and Sweden during introduction of nationwide screening: prospective cohort study. BMJ 2004;328:921-924.
Fracheboud J, de Gelder R, Otto SJ, Van Ineveld BM, Otten JD, Broeders M, Verbeek AL, den Heeten G, Holland R, de Brijn AE, de Koning H: National Evaluation of Breast Cancer Screening in the Netherlands 1990-2007. Rotterdam, National Evaluation Team for Breast cancer screening (NETB), 2009.
- Beral V, Cush S, Ellis IO, Emery J, Faulkner K, Given-Wilson R, Law M, Loughlin J, Michell MJ, Moss S, Noblet M, Patnick J, Reed M, Rubin C, Toward K, Winstone D, Austoker J, Berrington A, Blanks R, Day N, Day T, Moller H, Quinn M, Wallis MG, Wilson ARM: Screening for Breast Cancer in England: Past and Future. Sheffield, Advisory Committee on Breast Cancer Screening, 2006, NHSBSP Publication No. 61.
- Autier P, Koechlin A, Smans M, Vatten L, Boniol M: Mammography screening and breast cancer mortality in Sweden. J Natl Cancer Inst 2012;104:1080-1093.
- Weedon-Fekjaer H, Bakken K, Vatten LJ, Tretli S: Understanding recent trends in incidence of invasive breast cancer in Norway: age-period-cohort analysis based on registry data on mammography screening and hormone treatment use. BMJ 2012;344:e299.
- Puliti D, Duffy SW, Miccinesi G, de Koning H, Lynge E, Zappa M, Paci E: Overdiagnosis in mammographic screening for breast cancer in Europe: a literature review. J Med Screen 2012;19(suppl 1):42-56.
- Smith-Bindman R, Ballard-Barbash R, Miglioretti DL, Patnick J, Kerlikowske K: Comparing the performance of mammography screening in the USA and the UK. J Med Screen 2005;12:50-54.
- Hofvind S, Geller B, Vacek PM, Thoresen S, Skaane P: Using the European guidelines to evaluate the Norwegian Breast Cancer Screening Program. Eur J Epidemiol 2007;22:447-455.
- Urbschat I, Heidinger O: (Determination of interval cancer rates in the German mammography screening program using population-based cancer registry data). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014;57:68-76.
Tornberg S, Kemetli L, Ascunce N, Hofvind S, Anttila A, Seradour B, Paci E, Guldenfels C, Azavedo E, Frigerio A, Rodrigues V, Ponti A: A pooled analysis of interval cancer rates in six European countries. Eur J Cancer Prev 2010;19:87-93.
- Heidinger O, Batzler WU, Krieg V, Weigel S, Biesheuvel C, Heindel W, Hense HW: The incidence of interval cancers in the German mammography screening program: results from the population-based cancer registry in North Rhine-Westphalia. Dtsch Arztebl Int 2012;109:781-787.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.