title: Routine breast screening for women aged 65-69: results from evaluation of the demonstration sites.
abstract: Routine programme data and specially designed surveys from 3 demonstration sites were analysed to determine the implications of extending the NHS Breast Screening Programme (NHSBSP), to include routine invitations for women up to 69 years. All women aged 65-69 and registered with GPs in these areas received routine invitations for breast screening along with those aged 50-64. Overall uptake was 71% in women aged 65-69 compared with 78% in younger women, but was > or = 90% in both groups who had previously attended within 5 years. Recall rates were lower for older women, but with a higher positive predictive value for cancer. The percentages of invasive cancer in different prognostic categories were similar in the 2 age groups. Older women took no longer to screen than younger women. The costs per woman invited or per woman screened were also similar to those for women aged 50-64, whilst the cost per cancer detected was some 34% lower in older women. Breast screening is as cost effective for women aged 65-69 as for those aged 50-64, with a higher cancer detection rate balancing shorter life expectancy. The proposed extension to the national programme will have considerable workforce implications for the NHSBSP and require additional resources.
authors.affiliation: Cancer Screening Evaluation Unit, Section of Epidemiology, The Institute of Cancer Research, Block D, Cotswold Road, Sutton, Surrey, SM2 5NG.
authors.forename: S M
authors.initials: SM
authors.lastname: Moss
authors.forename: J
authors.initials: J
authors.lastname: Brown
authors.forename: L
authors.initials: L
authors.lastname: Garvican
authors.forename: D A
authors.initials: DA
authors.lastname: Coleman
authors.forename: L E
authors.initials: LE
authors.lastname: Johns
authors.forename: R G
authors.initials: RG
authors.lastname: Blanks
authors.forename: G
authors.initials: G
authors.lastname: Rubin
authors.forename: J
authors.initials: J
authors.lastname: Oswald
authors.forename: A
authors.initials: A
authors.lastname: Page
authors.forename: A
authors.initials: A
authors.lastname: Evans
authors.forename: P
authors.initials: P
authors.lastname: Gamble
authors.forename: R
authors.initials: R
authors.lastname: Wilson
authors.forename: L
authors.initials: L
authors.lastname: Lee
authors.forename: J
authors.initials: J
authors.lastname: Liston
authors.forename: L
authors.initials: L
authors.lastname: Sturdy
authors.forename: G
authors.initials: G
authors.lastname: Sutton
authors.forename: G
authors.initials: G
authors.lastname: Wardman
authors.forename: J
authors.initials: J
authors.lastname: Patnick
authors.forename: R
authors.initials: R
authors.lastname: Winder
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008017:Life Expectancy; D008403:Mass Screening / Q000191:economics / Q000592:standards*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010349:Patient Compliance; D011379:Prognosis; D015397:Program Evaluation; D013222:State Medicine; D006113:United Kingdom