In autumn 2005, Germany’s first screening unit started the biggest organized mammography screening program world-wide. Based on the European Guidelines and enacted by a decision of the German Bundestag, it is offered to women between 50 and 69 years of age. For about a decade prior to this decision, medical societies, medical professionals and women’s organizations debated the implementation controversially. Finally the supporter of screening gained the upper hand. But until today women in our country are not given the chance to make an informed decision as explicitly defined in the European Guidelines. Independent evidence-based information on harms of mammography screening is not available. The character of public campaigns on mammography screening resembles rather the promotion of screening.
The pharmaceutical and diagnostic industries supported the nationwide establishment of mammography screening by sponsoring relevant women’s organizations.

The German program aimed at eliminating serious lack of quality in mamma diagnostics as well as putting an end to decades of “grey / wild” screenings. Benefits of mammography screening and promises to reduce the breast cancer mortality somersaulted and are dominating the public discourse in German mass media to this day. The world-wide scientific community can now watch the development of the situation in Germany.

Currently about half of the women between 50 and 69 years of age are accepting the invitation for mammography screening. So far we see a massive increase in breast cancer incidence while breast cancer mortality still doesn’t drop. After estimated 47.500 women in May 2005(1), German epidemiological cancer registers are now publishing figures of a much higher incidence and the German Society for Senology (Deutsche Gesellschaft für Senologie) announced 74.500 new cases for 2012(2).

Not even speaking about false positive findings which cause sorrow and pain, for those women and families affected by the disease a return into a life without cancer and the aftermath of a therapy which is still highly invasive is not possible.

However, a healthy living environment and the avoidance of unnecessary risks remain disregarded in Germany while, at the same time, access to independent medical consultation and less invasive medical care are rather deteriorating in our new economy-driven health care system. Are these the praised services for the benefit of women’s health?

Gudrun Kemper, Beate Schmidt – Breast Cancer Action Germany

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(1) Gesundheitsberichterstattung des Bundes, May 2005, p. 7 and last page, http://www.rki.de/DE/Content/Gesundheitsmonitoring/Gesundheitsberichterstattung/GBEDownloadsT/brustkrebs.pdf

(2) Press release German Society of Senology, 24 July 2012, http://www.pressrelations.de/new/standard/result_main.cfm?r=502703&sid=&aktion=jour_pm&quelle=0&n_firmanr_=117635 , see also Robert Koch-Institut, 21 May 2012,
http://www.krebsdaten.de/Krebs/DE/Content/Krebsarten/Brustkrebs/brustkrebs_node.html