The Population-Based Mammography Screening Programme in Germany: Uptake and First Experiences of Women in 10 Federal States

Purpose: Within the statutory health insurance (SHI) cancer early detection programme (KFU) an organised, population-based, quality-assured mammographic screening programme in Germany was initiated for women aged 50-69 years in 2004. The aim of the study was to evaluate uptake and first experiences of participants with this new screening approach and to evaluate the background of knowledge, attitudes and intention to address a needs-assessed communication strategy. Materials and Methods: A representative, explorative survey within the female population was conducted in 10 federal states. A telephone survey of randomly selected 68 188 contacts was performed, 9 004 women gave informed consent to evaluate rates of invitation and uptake followed by a mailed questionnaire. Of these, 3 469 were returned and 3 226 were analysed. Results: The invitation rate of the programme was 56.6%, the uptake of mammographic screening was 66%, and the screening coverage rate was 37.3%. 90% of the participants were insured by SHI, women with lower socio-economic strata were attracted in accordance with the data of the general population. 61% of all women did not know that the risk of breast cancer increases with age and 56% believed that screening prevents breast cancer. 62.1% judged their own risk to be low. A physician's recommendation to participate was significantly associated with attendance (p < 0.05). 90% of the participants would follow the next invitation. Conclusion: The KFU targeted group of women was reached and the organised mammography screening programme was well perceived by invited women. For developing a lasting communication strategy information deficits have to be considered along with beliefs and attitudes of elegible women.