Attempts to evaluate a non-randomized breast cancer screening programme (the ‘DOM-project’)

In December 1974 a non-randomized breast cancer screening programme was initiated for women born between 1911 and 1925 in the city of Utrecht (The Netherlands). The organization, response and early outcomes were encouraging. The late outcomes i.e., long-term benefits, were analysed by comparing the Utrecht findings with mortality data for other large cities in The Netherlands which do not operate screening programmes. No great differences were seen. Nevertheless, some long-term benefit was forecast by a case-control study - the odds ratio of dying from breast cancer among ever-screened women compared with that in never-screened women was 0.29 (95% confidence interval: 0.14–0.62).