Breast cancer screening programme in The Netherlands: an interim review

The year 1988 saw the introduction of a nationwide breast cancer screening programme in the Netherlands. Some 10 years on, a network that extended throughout the country was in place and all women in the target group had been invited to undergo screening at least once. Of the original target group, which was made up of women aged 50-70, around 80% responded to this invitation, an indication of their trust. Is that trust justified? and do the results justify the enormous effort of all those who make the screening programme possible, the cooperation of the nearly 4 million women who by now have taken part and the 17 million pound sterling that are currently needed per year to fund the programme? The time has come to assess and review. The ultimate test is obviously whether women participating in the screening programme have a lower chance of dying of breast cancer than women not participating in the programme. Yet, as the breast cancer screening programme is one of the best documented facilities in the Dutch health care system, a reliable mid-term review can be made. The article by Fracheboud that appears in this issue provides a number of important results. Important elements of this programme are considered in this review.