Breast cancer screening implementation and reassurance

Background: Women not offered screening mammography reported higher levels of negative psychosocial aspects than women offered screening. This was demonstrated in a questionnaire survey where 1000 women were included: 500 women living in areas where the public authorities had never offered screening mammography and 500 women living in areas where women had been invited to screening mammography for >10 years. After this baseline survey, nationwide screening mammography was implemented. The aim of this follow-up study was to resurvey the 1000 women and to investigate if the identified difference in reported psychosocial aspects had disappeared or been reduced because of the nationwide screening implementation. Methods: The 1000 women included in the previous survey were posted part I of the questionnaire Consequences of Screening in Breast Cancer (COS-BC1) in August 2011, nearly 5 years after they received the COS-BC1 the first time. Results: A total of 677 women returned the questionnaire. There was no statistically significant difference between the two groups in reported psychosocial aspects. Women new to screening reported less negative psychosocial aspects compared with the previous survey. Conclusion: An implementation of a screening mammography programme provides reassurance for those women invited to the screening. This reassurance is in contrast to the unbalanced proportion between the intended benefits and the unintended harms of the screening programme.