Economie de la santé, 8, rue Fondary, 75015 Paris, France.
In France, one fears that opportunistic screening levels have risen in parallel with the development of district screening programmes. However the absence of a specific nomenclature for mammography renders its evaluation difficult. This study aims to quantify the importance of opportunistic screening in 2 districts with existing screening programmes. Mammograms done outside of the screening programmes were identified using Sickness Fund data. Reasons for prescription were identified through a survey of radiologists. These data were compared to programme attendance rates. In 1995, 9% of women aged 40 years or more had a mammogram outside of the screening programme. This rate is higher among women under the age of 55 when compared to older women. Opportunistic screening accounted for 27% of mammograms outside the screening programme, yet this rate reached 58% if one includes mammograms in asymptomatic women with personal or family risk factors. The data presented in this study confirm the importance of opportunistic screening in France, namely in peri-menopausal women. Screening programmes allow for the continuous evaluation of the quality and effectiveness of screening. The coexistance of opportunistic and organized screening should not be permitted to continue. The results of ongoing cost-effectiveness studies will allow to determine the relative cost-effectiveness of organized screening in France.