TABLE 3-1 Breast Screening Programs in Different Countries*

 

United States

Canada

Year screening program started

1988

(Medicare)

1988

(British Columbia was the 1st province)

Age of women screened (target population)

40 and older, generally until 75

50 to 69

Screening interval (years)

1-2

2ii

Percent of target population screened

55-63%iv

54%v

Referral type

Doctor or

self-referral

Doctor or

self-referral

Double readingx

Somexi

No

Number of views

2

2

Quality enforcement

National law (MQSA)xiv

Voluntary accreditationxv

Quality assurance site visits

Yes

No

Level of organization

Medicare is national; otherwise based on state and private insurance provider policiesxx

Provincexxi

*Finland, Luxembourg, and Japan also have national mammography screening programs; Italy, Spain, and Norway have regional programs.

iSwedish governments makes guidelines, but standards and practices are organized at the county level.

iiThe Canadian Province of British Columbia offers annual mammograms.

iiiScreening interval established individually by county.

ivBased on year 2000 data from Behavioral Risk Factor Surveillance System Public Use Data Tape (CDC, 2001). Also National Health Interview Survey, 2000 (CDC 2002); women over 40, and mammograms in last year; ACS Breast Cancer Facts and Figures 2003-2004.

vBased on 1996 data; Paquette et al. (2000); mammogram in past 2 years.

viBased on 2001-2002 data; NHS Breast Screening Programme Annual Review 2003.

viiBased on WE trial 1977-1979; attendence after first invitation; Lynge et al.

viiiShould be range b/c age policies differ; WE trial data is old (1977) and small sample size, but all studies go back to this same ref.

ixBased on 1990-1995 data; Facheboud et al., 1998, Int. J. Cancer.

xISBN http://appliedresearch.cancer.gov/ibsn/data/double.html. Accessed February 4, 2004.

xiThe United States does not require double reading of mammograms, but the practice is common. However, overall, double reading of screening mammograms is less common in the United States than other countries.



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