A comparison of the performance and impact of breast cancer screening programmes in East Anglia, UK and Bouches du Rhone, France

The purpose of this study was to compare results from the first screening round of two breast cancer screening programmes of similar design implemented in different health care settings. The East Anglian programme is part of the U.K. National Health Service Breast Screening Programme, which is a centralised programme with a Limited number of dedicated screening units. The Bouches du Rhone programme is one of 13 French programmes based on a decentralised model using existing radiology clinics. Compliance and cancer detection rates were lower in the Bouches du Rhone programme. Detection rates for small invasive cancers (less than or equal to 20 mm) were similar in the two programmes, although larger cancers (greater than or equal to 20 mm) were detected in the Bouches du Rhone programme. Significantly, the shift towards more favourable distribution of prognostic characteristics associated with screen-detected breast cancers compared with those arising outside the programme is less marked in the Bouches du Rhone programme. This is probably due to the more favourable underlying disease status in the district resulting from a long history of breast awareness and spontaneous mammography. (C) 1997 Elsevier Science Ltd.