This report has three objectives:
(1) to analyse the impact of breast cancer screening on breast cancer mortality according to different screening strategies (age group and interval between mammographies),
(2) to estimate the cost-effectiveness of these strategies and
(3) to estimate the impact ofscreening on the health care system.
Breast cancer is the largest cause of cancer among Catalan women and it is estimated that there are 2,500 new cases each year (crude rate: 71.6 per 100,000 inhabitants per annum). In recent years a trend towards an increase in this figure has been observed. Catalonia falls in the intermediate-low segment of the European Union countries. Every year 1,000 women die from breast cancer in Catalonia. The mortality rate in recent years also shows a growing trend towards an increase in this disease, mainly in women aged over 65.
In Catalonia it has been recommended that breast cancer screening should be by biannual mammography for women aged 50-64 years. Once adequate coverage has been achieved for this age group, screening could be extended to the 65-69 age group and later to the 45-49 age group, providing that scientific evidence is conclusive for the latter age group. Currently screening programmes are operative in Molins dei Rei - Cornella, Mataro, Ciutat Vella-Sant Marti (Barcelona) and Sabadell-Cerdanyola, which cover 11% of the population of women aged 50-64 years. Other programmes in other health care regions are still in the planning stages.