Explaining Variations in Breast Cancer Screening Across European Countries

This paper explores variations in the uptake of breast cancer screening and associated factors influencing utilisation of mammography screening among women aged 50 to 69 years in 13 European countries. We focus on the relative importance of individual (e.g. age, education, etc.) and institutional (e.g. public screening program) factors in explaining cross-country variation in the utilisation of mammograms. We take advantage of (a) newly available individual level data from the SHARE as well as (b) regional and country level data on institutional factors. We find that observed individual factors like age, education, health status, etc. are associated with screening uptake within countries but cannot statistically explain cross-country differences. In contrast, observed institutional factors like the availability of an organized screening program can statistically explain about 40 per cent of the between country differences in screening rates.