Lessons learned from mammography screening

Background: The quality-assured German mammography screening program has now been in operation throughout the country for 10 years. Aim: The experience gained over the years by the implementation of mammography screening has taught us important lessons to be considered for the introduction of any new screening program. Material and methods: During the course of the program it was necessary to continuously adapt binding guidelines regarding documentation and quality assurance. Additionally, new legal frameworks and information material for clients had to be developed. The impacts of these changes on the procedures, in particular the methods of communication within the mammography screening program are presented in this article. Results and discussion: Prior to the introduction of new screening programs, test methods have to come under closer scrutiny and should be assessed with respect to broader issues at an earlier stage. The frequency and invasiveness of additional and follow-up examinations, as well as an evaluation of potential overdiagnosis and associated overtreatment is of particular importance. A structured data matching between the screening program and the national registry in order to identify interval diseases and to calculate sensitivity and specificity of the screening method is obligatory. The information material accompanying the invitation to screening must clearly convey the pros and cons of a screening program for the target group in order that an informed decision can be made. © 2017, The Author(s).