Screening Uptake in a Well-Established Diabetic Retinopathy Screening Program

Leese, Graham; Boyle, Paul; Feng, Zhiqiang; Emslie-Smith, Alistair; Ellis, John

doi:10.2337/dc08-1098

Cited by 103 publications

(110 citation statements)

References 19 publications

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“…The recruitment rate among screening attendees in the area where the mean deprivation score for study participants was the lowest was 60% higher than in the area where the mean deprivation score was the greatest. This is consistent with a number of other studies involving uptake of health screening and interventions (33)(34)(35)(36) but is of concern because although women in the most deprived social groups have a lower incidence of breast cancer (37), they also have poorer survival (38). Any introduction of risk-adjusted breast screening must, therefore, consider how to minimize the potential healthcare inequality that might result.…”

Section: Discussionsupporting

confidence: 88%

Assessing Individual Breast Cancer Risk within the U.K. National Health Service Breast Screening Program: A New Paradigm for Cancer Prevention

Evans

Warwick

Astley

et al. 2012

Cancer Prevention Research

109

121

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The aim of this study is to determine breast cancer risk at mammographic screening episodes and integrate standard risk factors with mammographic density and genetic data to assess changing the screening interval based on risk and offer women at high risk preventive strategies. We report our experience of assessing breast cancer risk within the U.K. National Health Service Breast Screening Program using results from the first 10,000 women entered into the "Predicting Risk Of breast Cancer At Screening" study. Of the first 28,849 women attending for screening at fifteen sites in Manchester 10,000 (35%) consented to study entry and completed the questionnaire. The median 10-year Tyrer-Cuzick breast cancer risk was 2.65% (interquartile range, 2.10-3.45). A total of 107 women (1.07%) had 10-year risks 8% or higher (high breast cancer risk), with a further 8.20% having moderately increased risk (5%-8%). Mammographic density (percent dense area) was 60% or more in 8.3% of women. We collected saliva samples from 478 women for genetic analysis and will extend this to 18% of participants. At time of consent to the study, 95.0% of women indicated they wished to know their risk. Women with a 10-year risk of 8% or more or 5% to 8% and mammographic density of 60% or higher were invited to attend or be telephoned to receive risk counseling; 81.9% of those wishing to know their risk have received risk counseling and 85.7% of these were found to be eligible for a risk-reducing intervention. These results confirm the feasibility of determining breast cancer risk and acting on the information in the context of population-based mammographic screening. Cancer Prev Res; 5(7);

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Section: Discussionsupporting

confidence: 88%

Assessing Individual Breast Cancer Risk within the U.K. National Health Service Breast Screening Program: A New Paradigm for Cancer Prevention

Evans

Warwick

Astley

et al. 2012

Cancer Prevention Research

109

121

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“…Around 79% of individuals invited for diabetic eye screening in England took up the offer of screening in 2010/2011 [4]. Patients who do not attend for screening have poorer HbA 1c and blood pressure control [7] and have been diagnosed with diabetes for longer [7,8], all of which are risk factors for developing retinopathy [8][9][10][11][12][13][14][15]. These observations suggest that patients who do not attend for eye screening might be at increased risk of diabetic eye disease.…”

Section: Introductionmentioning

confidence: 99%

Non-attendance at diabetic eye screening and risk of sight-threatening diabetic retinopathy: a population-based cohort study

Forster

Forbes

Dodhia³

et al. 2013

Diabetologia

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Aims/hypothesis This study evaluated whether repeated nonattendance for diabetic eye screening is associated with the risk of sight-threatening diabetic retinopathy (STDR). Methods This was a cohort study of 6,556 residents with diabetes who were invited for screening between 2008 and 2011 in a population-based eye screening programme in inner London and who attended for their first-ever screen in 2008. The proportion of participants with STDR was evaluated in relation to the number of years in which screening was missed.Results The proportion of participants who did not attend screening decreased between 2009 and 2011 (annual reduction 1.6% [95% CI 0.9%, 2.3%]). The adjusted relative odds of STDR for 210 participants who did not attend two consecutive years of screening were 3.76 (95% CI 2.14, 6.61; p<0.001), compared with participants who were screened annually. In 605 participants with mild non-proliferative retinopathy at the first screen, the adjusted relative odds of developing proliferative or moderate to severe nonproliferative retinopathy were 5.72 (95% CI 7.43, 22.83; p=0.013) for 53 participants who missed two screens. Conclusions/interpretation Patients who do not attend diabetic eye screening are at increased risk of developing STDR. Tracing of non-attenders with evidence of established retinopathy should be an important fail-safe procedure.

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“…patient age – young adult people had a higher propensity for non‐attendance at diabetic retinopathy screening 13, 14;…”

Section: Discussionmentioning

confidence: 99%

“…One missed attendance at a retinal screening appointment is associated with a threefold increase in needing laser photocoagulation subsequently 13.…”

Section: Discussionmentioning

confidence: 99%

Screening attendance, age group and diabetic retinopathy level at first screen

Scanlon¹,

Stratton²,

Leese

et al. 2015

Diabet. Med.

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AimsTo report on the relationships between age at diagnosis of diabetes, time from registration with the screening programme to first diabetic eye screening and severity of diabetic retinopathy.MethodsData were extracted from four English screening programmes and from the Scottish, Welsh and Northern Irish programmes. Time from diagnosis of diabetes to first screening and age at diagnosis were calculated.ResultsTime from registration with the screening programme to first screening episode is strongly related to age at registration. Within 18 months of registration 89% of 3958 young people under 18 years of age and 81% of 391 293 people over 35 years of age were seen. In 19 058 people between 18 and 34 years of age, 80% coverage was not reached until 2 years and 9 months. The time from diagnosis of diabetes to first screening is positively associated with severity of disease (P < 0.0001).ConclusionsThis report is the first that to demonstrate that those in the 18–34 year age group are least likely to attend promptly for screening after registration with a higher risk of referable diabetic retinopathy being present at the time of first screen. Date of diagnosis should be recorded and prodigious efforts made to screen all people promptly after diagnosis. Screening programmes should collect data on those who have not attended within one year of registration.

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Screening Uptake in a Well-Established Diabetic Retinopathy Screening Program

Cited by 103 publications

References 19 publications

Assessing Individual Breast Cancer Risk within the U.K. National Health Service Breast Screening Program: A New Paradigm for Cancer Prevention

Assessing Individual Breast Cancer Risk within the U.K. National Health Service Breast Screening Program: A New Paradigm for Cancer Prevention

Non-attendance at diabetic eye screening and risk of sight-threatening diabetic retinopathy: a population-based cohort study

Screening attendance, age group and diabetic retinopathy level at first screen

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