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Service breast cancer screening is difficult to evaluate because there is no unscreened control group. Due to a natural experiment, where 20% of women were offered screening in two regions up to 17years before other women, Denmark is in a unique position. We utilized this opportunity to assess outcome of service screening. Screening was offered in Copenhagen from 1991 and Funen from 1993 to women aged 50-69years. We used difference-in-differences methodology with a study group offered screening; a historical control group; a regional co