EXPERIENCES OF MASS BREAST-CANCER SCREENI NG WITH MAMMOGRAPHY IN FRANCE - A COMMON EVALUATION PROTOCOL

In the framework of the National Fund for Prevention, Health Education and Information, the setting-up in France, on an experimental basis, of mass breast cancer screening programs by mammography in ten departm ents leads lo suggest a common protocol for the evaluation of these pr ograms, before an eventual generalization to the whole country. These programs are based on common principles: local screening based on exis ting medical facilities, single view mammography with double reading. However, the screening organisation is different in each department ac cording to the target population, the screening interval, the mode of invitation, the methods for arranging double reading, etc. The purpose of this article is to report on the work of the evaluation group of t he ten programs, and to propose a methodology for comparing the screen ing experiences in order to measure the role of the organisation metho ds. It gives definitions and modes of calculations for the evaluation criteria in four fields: impact, quality, efficacy and cost (with deta ils about the feasability of data collection) and proposes a reflectio n on analysis techniques in order to develop an optimum mass screening strategy.