[The effectiveness of the Hungarian mammography screening program]

Introduction: Mammography screening enabling early detection of breast cancer among women aged 45–65 has been available in Hungary since 2002. Objective: Our aim was to assess the effectiveness of the Hungarian mammography screening program based on the frequency of appearance and health outcomes of breast cancer patients. Method: Data on women aged 45–64 undergoing mammography screening between 2010 and 2021 was acquired from the National Health Insurance Fund. Frequency and regularity of screening was analyzed by age and place of residence. Patients receiving breast cancer treatment between 2013 and 2020 were identified and classified into molecular subtypes based on the provided care. The relationship between screening and lymph-node or other organ metastases and mortality was identified by univariate and multivariate analyses. Results: Screening rates are decreasing. Screening at least 5 times during the study period was the highest in the oldest cohort (19.7%), the lowest among the youngest (12.7%). There are significant differences by county, possibly partly due to coding problems. Between 2013 and 2020, 26,530 women aged 45–64 were diagnosed with breast cancer. Rate of participation in screening (30.2%) within six months before treatment increases with age: 29.1% (45–49-year-olds) to 36% (60–64-year-olds). The highest proportion of screen-detected breast cancer was observed in the luminal A molecular sub-group (41.3%), while it was only 18.4% among triple-negative cases. Known metastasis at the start of treatment was 3.7%, lymph-node metastasis 14.0% among screen-detected patients. Respective rates were 14.4% and 18.0% for those not screened. 1- and 3-year mortality rates for the 2 groups were 1.2%, 5.3% and 6.5%, 16.6%, respectively. Mortality was the highest in the triple-negative and HER2E groups. Discussion: Willingness to participate in screening is higher among the elderly, but it is decreasing overall. In the case of breast cancer, health benefits of screening are evident compared to the unscreened population. Conclusion: Screening participation should be improved as it allows earlier disease detection and better survival. The effectiveness of screening women with higher risks more frequently than 2 years requires further research. Coding practice of screenings requires improvement. Orv Hetil. 2025; 166(43): 1689–1705.