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Dr. Chris de Wolf: Attitudes & Experiences of GPs to Breast Screening in Europe

Breast cancer is the most common cause of cancer death for women in Switzerland. 1340 women died of this disease in 2002. In the age group 50-70 years, 10% of the female mortality is due to breast cancer counting for 39% of all breast cancer deaths. It counts for 8510 potential lost life years, the highest number for all causes of mortality.

2007 will be an historical year for breast screening in Switzerland. An evaluation commission will decide at the end of this year if mammography screening remains in the basic provisions to be reimbursed by the health insurance companies.

The ‘mammograben’ in Switzerland is separating the French speaking cantons who offer screening as a public health strategy to all women aged 50-70 on their territory with the German and Italian speaking cantons where no such service is yet implemented. The risk of dying of breast cancer differs between cantons. Implementing a mammography screening public health programme is a political decision on cantonal level.

Over the last 20 years, many European countries decided to introduce national breast cancer screening programmes following the example of the Netherlands, UK, Finland, Sweden and Iceland. The latest information on organisation and participation will be presented.

GPs have very little role in the French speaking countries in the screening programmes. The direct access to specialised services in particular to the gynaecologists, (the female GP) is the cause for this.

Some creative examples will be given on invitation strategies in southern European countries.