Cumulative attendance, assessment and cancer detection rate over four screening rounds in five English breast-screening programmes: a retrospective study

Wallis, Matthew; Neilson, F.; Hogarth, Helen; Whitaker, C. J.; Faulkner, K.

doi:10.1093/pubmed/fdm020

Cited by 9 publications

(11 citation statements)

References 17 publications

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“…This is higher than the cumulative false-positive rates over 10 screens of 8-21%, predicted on the basis of 3-5 screening rounds in women aged 50 to 69 in Denmark (19), and higher than the 21% risk over 20 years of biennial screening for women aged over 50 in Norway (20). The Age trial rate is also higher than the 10-11% cumulative false-positive rate estimated from NHSBSP cancer detection and cumulative assessment rate data for four screening rounds at five units published by Wallis et al (21). However, the Age trial rate is significantly lower than most reported rates for US women aged under 50 which are of the order of 34% after five screens for women aged 40-49 (22).…”

Section: Discussionmentioning

confidence: 58%

False-Positive Results in the Randomized Controlled Trial of Mammographic Screening from Age 40 (“Age” Trial)

Johns

Moss

2010

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background False-positive recall is a recognised disadvantage of mammographic breast screening and the rate of such recalls may be higher in younger women, potentially limiting the value of screening below age 50. Methods Attendance and screening outcome data for 53 884 women in the intervention arm of the UK Age trial were analysed to report observed false-positive recall rates during 13 years of trial fieldwork. The Age trial was a randomised controlled trial of the effect of mammographic screening from age 40 on breast cancer mortality, conducted in 23 NHS Screening centres between 1991 and 2004. Women randomised to the intervention arm were offered annual invitation to mammography from age 40/41 to age 48. Results Overall, 7893 women (14.6% of women the intervention arm and 18.1% of women attending at least one routine screen) experienced one or more false-positive screen during the trial. The rates of false-positive mammography at first and subsequent routine screens were 4.9% and 3.2%, respectively. The cumulative false-positive rate over seven screens was 20.5%. Eighty-nine percent of women who had a false-positive recall at their previous screen attended their next invitation to routine screening. Conclusions Rates of false-positive recall in the Age trial were comparable with the national screening programme, however, the positive predictive value of referral was lower. Experiencing a false-positive screen did not appear to lessen the likelihood of re-attendance in the trial. Impact The question of greatly increased false-positive rates in this age group and of their compromising re-attendance is refuted by the findings of this study.

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Section: Discussionmentioning

confidence: 58%

False-Positive Results in the Randomized Controlled Trial of Mammographic Screening from Age 40 (“Age” Trial)

Johns

Moss

2010

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…There also appears to be a difficulty in ensuring continuity of uptake in the South Asian population, especially among Muslim women. Global figures which show a decreasing gap in breast cancer screening uptake over time between South Asian women and the majority population [7] might therefore mask differences in the continuity of uptake [34]. Just under half (45.6%) of Muslim women who undertook mammography in round 1 decided not to participate in both of rounds 2 and 5, mainly choosing instead to participate in just one of the two subsequent rounds.…”

Section: Discussionmentioning

confidence: 99%

Comparison of breast and bowel cancer screening uptake patterns in a common cohort of South Asian women in England

Price

Szczepura

Gumber

et al. 2010

BMC Health Serv Res

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BackgroundInequalities in uptake of cancer screening by ethnic minority populations are well documented in a number of international studies. However, most studies to date have explored screening uptake for a single cancer only. This paper compares breast and bowel cancer screening uptake for a cohort of South Asian women invited to undertake both, and similarly investigates these women's breast cancer screening behaviour over a period of fifteen years.MethodsScreening data for rounds 1, 2 and 5 (1989-2004) of the NHS breast cancer screening programme and for round 1 of the NHS bowel screening pilot (2000-2002) were obtained for women aged 50-69 resident in the English bowel screening pilot site, Coventry and Warwickshire, who had been invited to undertake breast and bowel cancer screening in the period 2000-2002. Breast and bowel cancer screening uptake levels were calculated and compared using the chi-squared test.Results72,566 women were invited to breast and bowel cancer screening after exclusions. Of these, 3,539 were South Asian and 69,027 non-Asian; 18,730 had been invited to mammography over the previous fifteen years (rounds 1 to 5). South Asian women were significantly less likely to undertake both breast and bowel cancer screening; 29.9% (n = 1,057) compared to 59.4% (n = 40,969) for non-Asians (p < 0.001). Women in both groups who consistently chose to undertake breast cancer screening in rounds 1, 2 and 5 were more likely to complete round 1 bowel cancer screening. However, the likelihood of completion of bowel cancer screening was still significantly lower for South Asians; 49.5% vs. 82.3% for non-Asians, p < 0.001. South Asian women who undertook breast cancer screening in only one round were no more likely to complete bowel cancer screening than those who decided against breast cancer screening in all three rounds. In contrast, similar women in the non-Asian population had an increased likelihood of completing the new bowel cancer screening test. The likelihood of continued uptake of mammography after undertaking screening in round 1 differed between South Asian religio-linguistic groups. Noticeably, women in the Muslim population were less likely to continue to participate in mammography than those in other South Asian groups.ConclusionsCulturally appropriate targeted interventions are required to reduce observed disparities in cancer screening uptakes.

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“…12 In the Age trial, 18.7% of the intervention arm (10,092 women) failed to attend any of the routine annual screening invitations they were offered. A study by Wallis et al 13 covering a cohort of women invited by the NHSBSP over a similar time period, but looking at four three-yearly screening rounds, found 10% of women failed to attend any screens. The same study reported that 62% of women attended all four screens and 77% attended three of the four offered screens.…”

Section: Discussionmentioning

confidence: 99%

Randomized Controlled Trial of Mammographic Screening from Age 40 (‘age’ Trial): Patterns of Screening Attendance

Johns

Moss

2010

J Med Screen

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Cumulative attendance, assessment and cancer detection rate over four screening rounds in five English breast-screening programmes: a retrospective study

Cited by 9 publications

References 17 publications

False-Positive Results in the Randomized Controlled Trial of Mammographic Screening from Age 40 (“Age” Trial)

False-Positive Results in the Randomized Controlled Trial of Mammographic Screening from Age 40 (“Age” Trial)

Comparison of breast and bowel cancer screening uptake patterns in a common cohort of South Asian women in England

Randomized Controlled Trial of Mammographic Screening from Age 40 (‘age’ Trial): Patterns of Screening Attendance

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