Breast cancer screening in Canada: climbing the diffusion curve

Results of breast cancer screening studies, which point to the efficacy of screening mammography in the 50 to 69 year age group, have been available for several years. A number of initiatives are underway in Canada in an attempt to assure that the diffusion for this technology occurs consistently and rapidly. This paper outlines the initiative of the Canadian Workshop Group of Breast Cancer Screening, which convened in 1988, as well as other national initiatives in this area. In addition, it describes the experience of one screening program in assessing and acting upon shortcomings in screening diffusion in its own province. Specifically, the use of letters of invitation, community mobilization, and mobile service delivery are briefly outlined. This illustrates the use of outcome-based research and programmatic service delivery in assisting the diffusion effort.