2019
DOI: 10.1007/s00330-018-5957-2
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An analysis of 11.3 million screening tests examining the association between recall and cancer detection rates in the English NHS breast cancer screening programme

Abstract: Question: How can we determine optimum recall rates in breast cancer screening? Findings: In this large observational study we show that increases in recall rates above defined levels are almost exclusively associated with false positive recalls and a very small increase in low/intermediate grade DCIS. Meaning: High recall rates are not associated with increases in detection of life threatening cancers. The models developed in this paper can be used to help set recall rate ranges that maximise benefit and mini… Show more

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Cited by 9 publications
(6 citation statements)
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“…Evaluating more than one prior screening exam may be valuable in this respect. Moreover, a recent study showed that increasing the recall rate mainly increased detection of low-grade and not high-grade cancer [34]. This is consistent with our results demonstrating a higher proportion of tumors of low and intermediate histological grade among missed/minimal signs than true; an increased recall rate would probably reduce the proportion of missed and minimal signs.…”
Section: Discussionsupporting
confidence: 92%
“…Evaluating more than one prior screening exam may be valuable in this respect. Moreover, a recent study showed that increasing the recall rate mainly increased detection of low-grade and not high-grade cancer [34]. This is consistent with our results demonstrating a higher proportion of tumors of low and intermediate histological grade among missed/minimal signs than true; an increased recall rate would probably reduce the proportion of missed and minimal signs.…”
Section: Discussionsupporting
confidence: 92%
“…In addition, the expected or accepted recall rate in the program may influence the incidence of interval cancer; by accepting a higher rate of recall, a higher number of subtle findingswhich otherwise may develop and be diagnosed as interval cancer -might be recalled for further assessment compared with a program in which very low recall rates are anticipated (180,181). However, a modelling study demonstrated that an increase in recall rate above approximately 7% resulted in only a slight increase in detection of low grade non-invasive cancers and no further increased detection of invasive and high grade non-invasive cancers (182).…”
Section: Dbt In Screeningmentioning
confidence: 99%
“…In England, observational data suggests increasing recall rate is not the answer to the poor sensitivity of mammography for high-grade cancers. There is a threshold maximum recall rate which is modelled to allow detection of 99% of the screendetectable cancers in the NHSBSP, which is 7% at the prevalent screen and 4% at incident screen [38]. Above this recall rate, very few extra cancers are found, mainly low-and intermediate-grade DCIS.…”
Section: The Effect Of Recall Ratementioning
confidence: 99%