REVIEW – July – August 2010

10 years of breast cancer screening in Estonia: achieving set aims step-by-step


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Mammography screening has proved to be effective in decreasing breast cancer mortality among women who participate in screening at regular intervals. As nationwide screening was started in Estonia quite recently, its long-term influence on breast cancer mortality is not yet clear. However, we can find first positive changes in relevant medical data. When in 2002 altogether 82 women (aged 50–64) died from breast cancer in Estonia (death rate 65) then in 2008 the corresponding figure for the same age group decreased to 74 (death rate 55), which means 15% less cases. The biggest problems are low participation rate and lack of a centralized screening registry. Yet in spite of several  difficulties, we have built up (step-by-step) a nationwide organized screening programme and formed a very good screening team. Cooperation between different institutions (Health Insurance Fund; Cancer Screening Foundation; participating hospitals and screening teams; Cancer Society) has been effective and fluent. About 20% of new cancer cases are diagnosed at screening today. Altogether 180 000 women participated in screening between 2002 and 2009. 799 cancers detected (4.2 per 1000 participants) and about 75% of them were in early stage. Our results are comparable to those of our Scandinavian colleagues. The European Commission declared in 2008 that Estonia has fulfilled  the requirements and regulations of the European Union concerning breast cancer  screening (Population-based; Nationwide; Rollout/complete).