To mark the month of pink October, devoted to the fight against breast cancer, the Ministry of Health has issued a reminder of the importance of breast cancer screening, which can detect tumours at an early stage and thus save lives.
Breast cancer: the leading cause of death from tumours in women
According to the latest statistics on the causes of death in Luxembourg in 2021, tumours are the leading cause of death in the population, and breast cancer is the most common female cancer and the main cause of death in women aged between 50 and 70. On a more global level, the World Health Organisation (WHO) reported in 2023 that almost one woman in 12 will develop breast cancer in her lifetime.
Yet there have been major advances in the treatment of breast cancer in recent decades. The WHO also reports that, in developed countries, the age-specific breast cancer mortality rate fell by 40% between 1980 and 2020. This improved rate is the result of early detection of breast cancer, followed by effective treatment based on a combination of surgery, radiotherapy and drug therapies.
The importance of screening: the mammography programme in Luxembourg
"Regular screening remains essential if we are to combat this disease more effectively, and it is important to raise awareness among the population at risk of breast cancer of the need to undergo screening," says Paulette Lenert, Luxembourg's Minister of Health.
Among those at risk, women aged between 50 and 70 are encouraged to get screened by taking part in the Health Department's organised breast cancer screening programme, known as the "mammography programme". This programme concerns women aged between 50 and 70 who are resident in Luxembourg and affiliated to the country's social security system. During this age period, they receive an invitation every 23 months to have a mammogram at one of the approved screening centres, located in one of Luxembourg's five hospitals.
This programme has since proved its effectiveness, and contributes every year to the medical care and appropriate treatment of women in whom cancer is detected. Between 1992 and 2022, the programme enabled 430,500 women aged between 50 and 70 to take part in a mammography screening test, and cancer was detected in 2,900 of them.
On average in Luxembourg, for every 1,000 mammograms carried out as part of the programme, 40 show abnormal results. Of these 40, further tests are carried out, and 7 will be diagnosed as having developed the disease.
In addition, a rigorous approach to interpreting mammograms is applied as part of this organised screening programme, with a real benefit in terms of detecting possible breast cancer: the principle of double or even triple reading. Mammograms are examined by an accredited radiologist at the screening centre, then reviewed by a second radiologist at the Health Department ("double reading"). If the interpretations of the two doctors differ, a third reading is carried out during a discussion between one of the first readers and one of the second readers.
This double-reading method is essential, as it enables an abnormality not seen by one of the radiologists to be discovered, and also reduces the number of unnecessary additional examinations. Thanks to this method, over 25% of cancers have been detected.
Study of the relationship between data from the screening programme and the Luxembourg National Cancer Register (RNC)
In addition, a joint study was carried out between the RNC and the Health Directorate's breast cancer screening programme between 2013 and 2018, the aim of which was to assess the effectiveness of the breast cancer screening programme for women aged between 50 and 70. The results showed that the cancers screened were less invasive, smaller, with fewer invaded lymph nodes, and were at a less advanced stage at the time of diagnosis compared with cancers diagnosed outside the programme.
The breast cancer screening programme in Luxembourg is therefore achieving its objectives of early detection of breast cancer and a better prognosis. This study provides the first set of indicators and a methodology for evaluating the breast cancer screening programme in Luxembourg. In addition, the study will provide valuable international knowledge on the use of high-resolution data from population-based cancer registries to evaluate cancer screening programmes.
Awareness-raising activities for pink October
To mark pink October, the Ministry of Health is taking part in a number of awareness-raising initiatives throughout the country and throughout the month of October:
- Awareness and information days will be organised in the country's various hospitals, in collaboration with the Cancer Foundation and the Think Pink and Europa Donna associations: on 10 October at the Centre hospitalier du Nord (CHDN), on 11 October at the Centre hospitalier du Luxembourg (CHL), on 18 October at the Hôpitaux Robert Schuman (HRS), on 20 October at the Centre hospitalier Emile Mayrisch (CHEM), on 27 October at the Zithaklinik.
- Minister Paulette Lenert will be present at the Broschtskriibslaaf organised by Europa Donna on Saturday 7 October in Hesperange Park, and will give the starting signal for the race.
- The Think Pink association is organising the Race for the Cure in Echternach on Sunday 15 October, and the Ministry of Health will be there to support the race.
- A digital campaign will be deployed on the networks, including a video explaining the symptoms of cancer and the importance of screening, and a radio spot is also planned.
Screening tests outside the preventive programme
Efforts to optimise the organisation of screening tests outside the prevention programme have also paid off. The actions of the working group set up, as well as collaboration between the Observatoire de la santé, the Luxembourg Institute of Health (LIH) and the Fédération des hôpitaux luxembourgeois (FHL), have contributed to a gradual improvement in waiting times. Urgent examinations are allocated at short notice, and consultation between hospital staff and the doctors concerned, with the support of the Health Department, makes it possible to offer appointments for examinations at short notice on the basis of the medical indications prescribed. The extension of opening times and the renewal of the stock of mammography machines in all hospitals over the coming weeks and months will help to ensure improved care when needed.
Press release by the Ministry of Health