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Participation rate or informed choice? Rethinking the European key performance indicators for mammography screening

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  • Strech, Daniel

Abstract

Despite the intensive controversies about the likelihood of benefits and harms of mammography screening almost all experts conclude that the choice to screen or not to screen needs to be made by the individual patient who is adequately informed. However, the “European guideline for quality assurance in breast cancer screening and diagnosis” specifies a participation rate of 70% as the key performance indicator for mammography screening. This paper argues that neither the existing evidence on benefits and harms, nor survey research with women, nor compliance rates in clinical trials, nor cost-effectiveness ratios justify participation rates as a reasonable performance indicator for preference-sensitive condition such as mammography screening. In contrast, an informed choice rate would be more reasonable. Further research needs to address the practical challenges in assessing informed choice rates.

Suggested Citation

  • Strech, Daniel, 2014. "Participation rate or informed choice? Rethinking the European key performance indicators for mammography screening," Health Policy, Elsevier, vol. 115(1), pages 100-103.
    • Handle: RePEc:eee:hepoli:v:115:y:2014:i:1:p:100-103
    DOI: 10.1016/j.healthpol.2013.11.012
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    Cited by:

    1. Missinne, Sarah & Bracke, Piet, 2015. "A cross-national comparative study on the influence of individual life course factors on mammography screening," Health Policy, Elsevier, vol. 119(6), pages 709-719.
    2. Ritchie, David & Van Hal, Guido & Van den Broucke, Stephan, 2020. "How is informed decision-making about breast cancer screening addressed in Europe? An international survey of 28 countries," Health Policy, Elsevier, vol. 124(9), pages 1017-1031.

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