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International Journal of Public Health

, Volume 60, Issue 8, pp 881–890 | Cite as

Breast cancer screening in England and the United States: a comparison of provision and utilisation

  • Joseph WilliamsEmail author
  • Linda Garvican
  • Anna N. A. Tosteson
  • David C. Goodman
  • Tracy Onega
Review

Abstract

Objectives

Comparing breast cancer screening across countries within the context of some of the benefits and harms offers the opportunity to improve effectiveness through mutual learning.

Methods

This paper describes the provision of breast cancer screening in England and the United States. The various recommendations for accessing breast cancer screening in the two countries are set out and the organisation of services including quality assurance, incentives and performance mechanisms considered.

Results

In the United States, younger women are routinely screened; they are less likely to benefit and more likely to be harmed. The utilisation of breast cancer screening amongst eligible women is broadly comparable in the two countries. However, there are differences in technical performance; the reasons for these including radiological reading procedures and cultural factors are explored.

Conclusions

Despite a well-functioning screening programme, breast cancer mortality and survival in England are poor relative to other countries. Emphasis for American improvement should be on reducing false-positive recall rates, while the English NHS could supplement existing efforts to understand and improve comparatively poor survival and mortality.

Keywords

Breast cancer Screening Mammography England United States 

Notes

Compliance with ethical standards

Conflict of interest

None of the authors declared any conflicts of interest.

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Copyright information

© Swiss School of Public Health (SSPH+) 2015

Authors and Affiliations

  • Joseph Williams
    • 1
    Email author
  • Linda Garvican
    • 2
  • Anna N. A. Tosteson
    • 3
    • 4
  • David C. Goodman
    • 3
  • Tracy Onega
    • 3
    • 4
  1. 1.Care Quality CommissionLondonEngland
  2. 2.South East Coast Cancer Screening QA Reference Centre, Public Health EnglandBattleEngland
  3. 3.The Dartmouth Institute for Health Policy and Clinical Practice at the Dartmouth School of Medicine at DartmouthLebanonUSA
  4. 4.Norris Cotton Cancer Center, Geisel School of Medicine at DartmouthLebanonUSA

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