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 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 Breast cancer screening with mammography in women aged 40–49 years: Impact of length of screening interval on effectiveness of the program

2020 ◽  
pp. 096914132091828
Author(s):  
Zheng Mao ◽  
Lennarth Nyström ◽  
Håkan Jonsson
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Cancer Mortality ◽  
Screening Program ◽  
Breast Cancer Mortality ◽  
Interval Cancers ◽  
Screening Interval ◽  
Using Data ◽  
The Impact

Objectives To estimate the impact on the effectiveness of Swedish breast cancer screening program in women aged 40–49 years of shortening the screening interval from 21 months to 18 or 12 months. Methods The reduction in breast cancer mortality among participants in screening with mammography was previously estimated in the Swedish SCReening of Young women (SCRY) study to be 29%. The expected increased effectiveness with a hypothetical shorter screening interval than the average of 21 months in SCRY was calculated using data about the women who died from breast cancer even though they participated in the SCRY program. Results During the study period, 547 women who participated in the index screening round died from breast cancer. Shortening the screening interval to 18 months led to an improved effectiveness of 0.7–3.9% considering interval cancers only and of 1.3–7.6% considering screening-detected cancers only, and for both interval and screening-detected cancers the improvement was 1.9–11.5% when the assumed mortality reduction for the deceased cases varied from 5% to 30%. Shortening the screening interval to 12 months increased the effectiveness by 1.6–9.8% for interval cancers and by 2.9–17.4% for both interval and screening-detected cancers. Conclusion Shortening the screening interval for women aged 40–49 years to 18 or 12 months might further reduce the breast cancer mortality rate.

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 Using Record Linkage to Examine the Impact of Poor Mental Health on Breast Screening Uptake

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Emma Ross ◽  
Dermot O'Reilly
Keyword(s):  
Mental Health ◽  
Breast Screening ◽  
Census Data ◽  
Breast Cancer Mortality ◽  
Poor Mental Health ◽  
Breast Screening Programme ◽  
Screening Uptake ◽  
National Breast ◽  
The Impact ◽  
Prescribing Information

BackgroundThe UK National Breast Screening Programme is estimated to reduce breast cancer mortality by 20%. To maximise the benefits of the programme, we first need to understand the underlying factors contributing to variations in screening uptake. One potentially significant factor which may contribute to these gradients in screening uptake is poor mental health. ObjectivesThe objectives of this study were to examine the impact of poor mental health on breast screening uptake, and whether this explained any of the previously observed socio-demographic gradients in screening uptake. MethodsBreast screening records were obtained from the National Breast Screening System (NBSS) and were subsequently linked to 2011 Census data within the Northern Ireland Longitudinal Study (NILS). The NILS encompasses 28\% of Census data. This was then linked to psychotropic prescribing information from the Enhanced Prescribing Database (EPD), to produce a de-identified research dataset containing 57,328 women. FindingsWomen with self-reported poor mental health were over 20% less likely to attend screening compared to their counterparts who didn't have poor mental health. Using psychotropic prescribing information as a proxy for the presence of mental illness yielded similar results, with those taking anxiolytics, antipsychotics or hypnotics in the three months before screening invitation significantly less likely to attend than those who were not. ConclusionWomen with poor mental health were significantly less likely to attend breast screening. However, poor mental health did not explain any of the previously determined socio-demographic gradients in screening uptake.

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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