POPULATION-BASED BREAST-CANCER SCREENING - POLICY ADVICE FOR A NEW-ZEALAND SCREENING-PROGRAM

The Ministry of Health appointed the Breast Cancer Screening Policy Ad visory Group in 1995 to provide policy advice on the establishment of a population-based screening programme in New Zealand. The group recom mended that an organised mammographic screening programme be part of a strategic approach to breast cancer detection and management with the aim of reducing mortality from breast cancer. Service specifications should be based on those of the pilot programmes in Otago-Southland an d Waikato, but modified according to the lessons learned, with special attention to such areas as recruitment and information systems.Women between the ages of 50-69 should be invited for screening every two ye ars, and screening should be free of charge. Because of the uncertain value of general population screening by mammography in women under th e age of 50, the programme should not be extended to younger women, in cluding those at high risk, at the present time. Further reviews of th e issue should be commissioned when new evidence becomes available. Pi lot programmes in New Zealand have demonstrated that screening can be performed with acceptable standards in comparison with overseas trials but considerable planning and commitment will be required for the exp ected benefits to be experienced nationally. Implementation of a succe ssful national programme will involve attention to key areas such as p rogramme management, recruitment and quality standards to deliver a hi gh quality service to a substantial proportion of the eligible populat ion.