he aim of the páper is to present a model of mammography screening, confront it with the first results and to draw attention to the importance of continuous examination otearly surrogate in-dicators. The authors ušed the model, which is based on the systém BI-RADS of the American College of Radiology in the samé way as the systém of uniform data collection MaSc. The modeling of effectiveness and cost of the screening was performed in ten samples of data, named D1-D3, B1-B3, S1-S4. The S1-S4 samples come from data obtained on the basis of pilot results of selected screening workplaces. The cost of individual examinations was modeled accord-ing to payment of VZP (General Health Insurance Company) valid in April 1 , 2003. The D1-D3, B1-B3 groups display similar proportion of women classified into category BI-RADS-0 (further examinations needed), but there are apparent differences in the composition of supplemen-tary imaging examinations. The real data D3, B3 in comparison with qualified estimates display a higher proportion of sonography examinations performed. Another method procedure emerged during classification into categories BI-RADS-1 and BI-RADS-2 with a different composition in the groups of the cohort D in comparison with the groups of the cohort B, while the common proportion in per cent of the sum BI-RADS-1 and BI-RADS-2 remains constant. The data indicate a high proportion of BI-RADS-3 against original estimates. The cancer detection rate is in the range of 0.41-1.7% of the examined women. The real mean cost of one examination in between 497 and 577 CKr, qualified estimates of this parameter appear to be excessive. There is apparent high cost in the groups of the cohort S in comparison with the groups D3, B2 and B3. It can be most probably explained by higher proportion of ultrasound examinations. The real diagnostic contribution of the increased proportion of ultra- sonography examinations cannot be evaluated for the relatively low number of malignancies. The proportion of follow-up examinations (recall rate) is substantially higher in all our models than the recommended values. The cost of screening for one patient in the Czech Republic (about 17 Euro) is low in comparison with neighboring countries. The obtained indicators of quality and efficiency of BCS reflect the pilot condition of BCS at the time of the data collection. It may be expected that data collected in a real screening within the framework of the MaSc project will display gradual stabilization. The first results should be available in the second half of 2004.

        Key words: breast cancer screening - early surrogate indicators - cost and effectiveness of screening