title: Diverging trends in breast cancer mortality within Switzerland.
abstract: BACKGROUND
  Substantial regional heterogeneity in the provision of cancer prevention and management services results from the decentralised Swiss healthcare system.
  
  
  METHODS
  Breast cancer mortality trends between 1980 and 2002 were compared in two French- and in two German-speaking female populations of Switzerland, aged 55-74 years, characterised by different access to, and use of, mammography screening.
  
  
  RESULTS
  Since the early 1990s, a 30% fall was observed in the French-speaking regions of Vaud and Geneva, where mammography screening is widespread, with no decline in the German-speaking areas of Basel and Zurich.
  
  
  CONCLUSIONS
  Modification in breast cancer diagnosis and management in selected regions of Switzerland is urgently needed.
authors.affiliation: Unité d'Epidémiologie du Cancer, Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland. Jean-Luc.Bulliard@chuv.ch
authors.forename: J-L
authors.initials: JL
authors.lastname: Bulliard
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
authors.forename: F
authors.initials: F
authors.lastname: Levi
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006801:Humans; D007802:Language; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D013557:Switzerland / Q000453:epidemiology