Implementation of service screening with mammography in Sweden: from pilotstudy to nationwide programme

Establishment of mammography screening in Sweden has progressed logically f rom pilot study through clinical trials to service screening. Screening wit h mammography for early detection of breast cancer has been provided by all Sweden's 26 county councils since 1997. It took 23 years from the initial pilot study through clinical trials to the establishment of mammography ser vice screening throughout Sweden. In the screening rounds completed by 1995-96, and provided by all but one c ounty council, 1 040 000 women participated, corresponding to 81% of those invited. The national average recall rate was 2.2%, and consequently 23 000 women were recalled for additional investigations. Eleven county councils invited women aged 40-74, six invited women aged 50-69, the remaining eight invited women between both these age intervals. Mammography outside screening programmes-clinical mammography-is available throughout Sweden. About 100 000 women a year were referred for clinical ma mmography and about 50% of these were either younger or older than those in vited for screening. A negative relation between the use of clinical mammog raphy and participation in the screening programmes was noticed.