Breast Cancer Screening Uptake Remains Low Among Women in Berlin

Participation rates in breast cancer screening programs among women in Berlin and Brandenburg remain significantly below international recommendations, despite the availability of a robust and quality-assured system. Current data from the Mammography Reference Center Berlin indicate that only about 50% of women who receive invitations to undergo mammography screening actually attend their appointments. This figure, although slightly improved from previous years, still falls short of the 70% participation rate recommended by the World Health Organization (WHO).

In Berlin, screening attendance rose from approximately 46% in 2022 to around 50% in 2024. Brandenburg saw a similar increase, with participation climbing from 52% to 55% over the same period. Notably, these rates are lower than those observed about a decade ago, when Brandenburg achieved participation rates exceeding 60%.

The reasons for limited engagement with the screening program are diverse. Some women opt for alternative methods of breast examination, such as ultrasound or manual palpation, instead of mammography. Others undergo diagnostic mammography as part of follow-up care after a prior breast cancer diagnosis; these women are not counted in screening statistics, which may result in underestimation of the actual level of breast health monitoring.

Additional factors contributing to low participation include apprehension about potential discomfort during the procedure, concerns regarding exposure to radiation, and misconceptions related to individual breast characteristics--such as size or density--and their suitability for mammography. Practical barriers, including inconvenient appointment times, a lack of clear information about rescheduling options, or confusion caused by the format of invitation letters, also play a role. In some cases, invitations are mistakenly discarded as unsolicited mail.

The German breast cancer screening program is recognized for its stringent quality standards. All imaging is subject to double assessment, and both equipment and medical personnel are required to meet rigorous criteria. In contrast, other forms of breast cancer detection are not systematically regulated or monitored to the same degree.

Substantial evidence supports the effectiveness of organized mammography screening. According to the Federal Office for Radiation Protection, the program, which has been in operation for two decades and is available to all women aged 50 to 75 through statutory health insurance, has led to a significant reduction in breast cancer mortality. Studies indicate that women who participate in regular mammography screening have a 20% to 30% lower risk of dying from breast cancer over a ten-year period compared to those who do not participate.

Breast cancer remains the most common form of cancer among women in Germany, with approximately 75,000 new cases diagnosed annually. Estimates suggest that one in eight women will be affected by the disease during their lifetime. Each year, around 18,500 women in Germany die from breast cancer, but it is projected that, without the screening program, the number of deaths would be several thousand higher.

Despite the proven benefits, increasing participation in the screening program remains an ongoing challenge. Experts emphasize the importance of raising awareness about the advantages of early detection and improving access to information, in order to reduce barriers and enhance attendance rates. Ensuring that women understand the high standards and life-saving potential of the screening program is considered essential for further reducing the burden of breast cancer in the region.