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Mortality from invasive breast cancer continues to fall in North America, Australia, and most western European countries. To assess the relative effects on breast cancer mortality of mammographic screening and improved treatment, investigators paired selected European countries based on geographic contiguity, socioeconomic status, and quality of and access to healthcare services. For each of three pairs (Sweden and Norway; the Netherlands and Belgium; Northern Ireland [U.K.] and the Republic of Ireland), nationwide mammographic screening had been implemented by 1990 in the first country and substantially later in the second. Breast cancer mortality was compared for each pair.
For example, national screening mammography was initiated in the m…