PREVALENCE OF SELF-REPORTED SCREENING MAMMOGRAPHY AND IMPACT ON BREAST-CANCER MORTALITY IN AUSTRIA

Mammography for breast cancer screening has been available in Austria free of charge since 1974 and has been explicitly recommended for mass screening since 1980. The type of screening is opportunistic. Evaluat ion has to rely on population-based data (mortality, stage distributio n, screening prevalence). In a representative cross-sectional study (w omen aged 40-79 years, n = 566, conducted in 1995) 58% reported at lea st one screening mammography; the lowest prevalence was found in the a ge group 70-74 years: 39.3%, the highest in the age group 50-54 years: 71.4%. 23.1% reported at least 2 mammograms within an interval of les s than 2 years; lowest prevalence 70-74 years: 10.7%, highest 50-54 ye ars: 35.7%. Age-standardized mortality rate has stabilized since 1985. Since 1980 age-specific rates have increased significantly in all age groups >54 years, but a decreasing tendency in most groups has been n oted since around 1990. The incidence rates of stage II or worse tumor s have increased significantly since 1982, except in the age groups 40 -44 and 55-59 years; however, during the past 3 to 6 years the absolut e rates of incidence of advanced tumors has decreased in alle age grou ps. The reduction of advanced cancers at diagnosis, followed by a redu ction of mortality rates is plausibly related to screening prevalence. More uniform decreasing trends should be expected in the years to com e. If not, discontinuation of the current opportunistic form of screen ing without monitoring and evaluation, financed by public money, has t o be discussed.