Breast Cancer Screening: Austria's Women Participate Too Rarely

Last year, proverbially "mixed" results were also shown in a nationwide evaluation of the data from the "early detection" program in Austria.

The St. Pölten radiologist Franz Frühwald, formerly at the forefront of establishing the quality-assured, structured project for nationwide breast cancer early detection and also active in the Austrian Medical Association, published the fourth evaluation of the "Austrian Breast Cancer Early Detection Program" (BKFP) in the medical journal "Universum Innere Medizin" about a year ago. This referred to the years 2020 and 2021.

Breast Cancer Screening: Participation Decline Due to Corona

"In the years 2020/2021, 614,835 women, which is 40 percent of the women in the core target group (aged 45 to 69), participated in the BKFP," wrote Frühwald. The participation rate decreased by one percent compared to 2018/2019, the previous two-year cycle (invitations to women every two years since the program began). Together with mammography examinations conducted for diagnostic reasons (suspected breast cancer), the coverage in the target group amounts to 53 percent.

A shortcoming, according to the report: "At the district level, participation (in the early detection program excluding, of course, the diagnostic examinations; note) fluctuates between twelve and 51 percent."

SARS-CoV-2 had a strong impact. "Due to the Covid-19 pandemic, there was a 12.5 percent decline in participation in 2020 compared to 2019. In 2021, participation increased by 22 percent compared to 2020 due to a catch-up effect. 59 percent of the participants in 2018/2019 participated again in the breast cancer early detection program in the intended interval two years later," Frühwald noted. However, there are also strong regional differences here. "The range of re-participation at the district level is between 37 and 72 percent."

In total, 2,584 invasive breast carcinomas were detected during the evaluation period as part of the program. In addition, there were 403 carcinomas in an early stage (ductal carcinomas, not yet invaded surrounding tissue). "78 percent of the detected invasive carcinomas had a diameter of 15 millimeters or less, about 43 percent of the carcinomas were smaller than ten millimeters at the time of detection. In 79 percent of the invasive carcinomas, an early detection revealed a prognostically favorable tumor stage of 0 or 1," the report stated.

The biggest shortcoming, according to Frühwald, is the continued lack of participation by Austrian women. In the professional literature, a participation rate of 70 percent is considered acceptable. More than 75 percent is desired.

Invitation to breast cancer screening alone is apparently not enough

In Austria, however, this participation rate is only 40 percent. The radiologist: "The participation rate, as well as the re-participation rate, remained below expectations and also below European guidelines and comparison values of other European countries in the years 2020/2021, partly due to the Covid-19 pandemic." This could also be a reason why nothing has changed in Salzburg with the introduction of the early detection program compared to before.

Possible countermeasures, as formulated by the Lower Austrian radiologist: "To increase participation, in addition to the invitation or reminder system, the communication level of trusted doctors should also be further promoted and expanded. Additionally, the different participation rates at the district level should continue to be analyzed and appropriate regional measures to increase participation should be implemented."

According to Frühwald, the quality of the Austrian program is "excellent." This applies to the detection of carcinomas as well as to the proportion of radiological quality of the examinations (99.88 percent "acceptable"). The women examined also received their results on average within 1.6 days. A significant advantage regarding quality is also the possibility of an immediate additional ultrasound examination, especially in cases of dense breast tissue or abnormalities. This increases the sensitivity in early detection by five percent.

(APA/Red)

This article has been automatically translated, read the original article here.