scholarly journals Breast cancer in East Anglia: the impact of the breast screening programme on stage at diagnosis

1998 ◽  
Vol 5 (1) ◽  
pp. 42-48 ◽  
Author(s):  
J McCann ◽  
D Stockton ◽  
N Day
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
Breast Screening ◽  
Screening Programme ◽  
Early Stage ◽  
Age Group ◽  
Interval Cancers ◽  
East Anglia ◽  
Breast Screening Programme ◽  
The Impact

Objectives To assess the impact of the National Health Service breast screening programme on overall and stage-specific incidence of breast cancer in East Anglia; also, to predict the magnitude of the screening induced reduction in breast cancer mortality. Setting Women resident in East Anglia aged 50–69, diagnosed between 1976 and 1995. Methods Comparison of numbers and incidence of breast cancer by age, stage, and mode of detection; investigation of relative contributions of advanced (stages II, III, and IV) cancers to total incidence by detection mode; estimation of the reduction in advanced cancer incidence. Results There has been a large increase in early stage incidence in the age group 50–64 targeted by the screening programme. By 1995, the estimated decrease in advanced cancer incidence was between 7 and 19%. In 1995, of all breast cancers arising in the age group 50–69 years, 33% were screen detected, 27% were interval cancers, 15% were in non-attenders, 9% were in lapsed attenders, 7% occurred before invitation, and 4% arose in women outside the birth year range for invitation. Of the advanced cancers diagnosed in 1995, 31% were interval cancers, 20% were screen detected, 19% were in non-attenders, 12% were in lapsed attenders, 8% occurred before invitation, and 4% presented in women outside the birth year range for invitation. Conclusions Screening has brought about a large increase in detection of early stage cancers. This increase has not yet been fully matched by a corresponding deficit in advanced cancers, possibly because the full effect of screening has not yet been achieved. Reducing the proportion of interval cancers is necessary to increase the effect of screening on mortality.

scholarly journals Effectiveness of a small breast screening programme: 25 year evaluation (25 year breast screening evaluation)

BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20180018
Author(s):  
Andrew Patric Nisbet ◽  
Andrew Borthwick-Clarke ◽  
Nic Scott ◽  
Helen Goulding ◽  
Harwood Jane
Keyword(s):  
Breast Cancer ◽  
Quality Control ◽  
Cancer Mortality ◽  
Breast Screening ◽  
Screening Programme ◽  
Breast Cancer Mortality ◽  
Interval Cancers ◽  
Breast Screening Programme ◽  
Small Breast ◽  
The Impact

Objective: To evaluate mammography screening quality on the Island of Jersey over a 25-year period from Jan 1990 to end March 2015 from females invited between ages 50 to 75 using a 2 yearly screening interval. Jersey had a population of only around 67,000 at onset, rising to around 100,000 at the end of the 25 years. Methods: An analysis was performed of key routinely collected measures that are important to determining if a screening programme is on course to reduce breast cancer mortality such as uptake, recall rates, screen detected cancer and interval cancer rates. Further supporting indicators including grade, stage and comparative deaths from breast cancer in screen detected and not screen detected females were also assessed. Results: Over the 25-year period 19,768 females were invited to screening and 16,866 attended, giving an uptake of 85.2%. There were 501 screen detected cancers of which 400 were invasive, and 101 DCIS. 125 interval cancers presented outside screening over the 25 years. The annual recall rate over the last 20 years was <6% for prevalent round and 4% for incident round screening. Based on the standardized detection ratio (SDR) and uptake, the estimated reduction in mortality from breast cancer was calculated as 40.2%. Conclusions: Recommended population sizes for breast units range from a quarter to half a million people. For very small units like Jersey serving smaller populations, rigorous quality control is essential to maintain credibility. Despite the small size of the programme evidence shows a similar detection rate to the UK NHS Breast screening programme was achieved. In small programmes careful monitoring of rates of uptake, recall, cancer detection and interval rates are required over adequate time periods together with supporting information to show that small units can achieve national standards and detection rates necessary to reduce breast cancer mortality. Advances in knowledge: Running a small breast cancer screening programme is challenging for quality control. The impact on mortality can be predicted for small screening programmes despite their size. 10-year group survival in screen detected invasive breast cancer >90%. Interval cancers are more advanced than screen detected invasive cancers, so high suspicion is still required in breast symptoms after "normal" screen result. Mortality in lapsed/ceased attenders suggest that extending age range could be beneficial.

scholarly journals A case-control study to evaluate the impact of the breast screening programme on mortality in England

2020 ◽  
Author(s):  
Roberta Maroni ◽  
Nathalie J. Massat ◽  
Dharmishta Parmar ◽  
Amanda Dibden ◽  
Jack Cuzick ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mammography Screening ◽  
Breast Screening ◽  
Case Control Study ◽  
Screening Programme ◽  
Case Control ◽  
Breast Screening Programme ◽  
Risk Of Death ◽  
The Impact ◽  
Control Study

Abstract Background Over the past 30 years since the implementation of the National Health Service Breast Screening Programme, improvements in diagnostic techniques and treatments have led to the need for an up-to-date evaluation of its benefit on risk of death from breast cancer. An initial pilot case-control study in London indicated that attending mammography screening led to a mortality reduction of 39%. Methods Based on the same study protocol, an England-wide study was set up. Women aged 47–89 years who died of primary breast cancer in 2010 or 2011 were selected as cases (8288 cases). When possible, two controls were selected per case (15,202 controls) and were matched by date of birth and screening area. Results Conditional logistic regressions showed a 38% reduction in breast cancer mortality after correcting for self-selection bias (OR 0.62, 95% CI 0.56–0.69) for women being screened at least once. Secondary analyses by age group, and time between last screen and breast cancer diagnosis were also performed. Conclusions According to this England-wide case-control study, mammography screening still plays an important role in lowering the risk of dying from breast cancer. Women aged 65 or over see a stronger and longer lasting benefit of screening compared to younger women.

scholarly journals The West Midlands breast cancer screening status algorithm – methodology and use as an audit tool

2005 ◽  
Vol 12 (4) ◽  
pp. 179-184 ◽  
Author(s):  
Gill Lawrence ◽  
Olive Kearins ◽  
Emma O'Sullivan ◽  
Nancy Tappenden ◽  
Matthew Wallis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Screening ◽  
Screening Programme ◽  
Breast Cancers ◽  
Audit Tool ◽  
The West ◽  
Breast Screening Programme ◽  
Multiple Primaries ◽  
West Midlands ◽  
Malignant Breast

Objectives: To illustrate the ability of the West Midlands breast screening status algorithm to assign a screening status to women with malignant breast cancer, and its uses as a quality assurance and audit tool. Methods: Breast cancers diagnosed between the introduction of the National Health Service [NHS] Breast Screening Programme and 31 March 2001 were obtained from the West Midlands Cancer Intelligence Unit (WMCIU). Screen-detected tumours were identified via breast screening units, and the remaining cancers were assigned to one of eight screening status categories. Multiple primaries and recurrences were excluded. Results: A screening status was assigned to 14,680 women (96% of the cohort examined), 110 cancers were not registered at the WMCIU and the cohort included 120 screen-detected recurrences. Conclusions: The West Midlands breast screening status algorithm is a robust simple tool which can be used to derive data to evaluate the efficacy and impact of the NHS Breast Screening Programme.

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