Routine breast screening for women aged 65-69: results from evaluation of the demonstration sites.
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.
Moss
S M
SM
Cancer Screening Evaluation Unit, Section of Epidemiology, The Institute of Cancer Research, Block D, Cotswold Road, Sutton, Surrey, SM2 5NG.
Brown
J
J
Garvican
L
L
Coleman
D A
DA
Johns
L E
LE
Blanks
R G
RG
Rubin
G
G
Oswald
J
J
Page
A
A
Evans
A
A
Gamble
P
P
Wilson
R
R
Lee
L
L
Liston
J
J
Sturdy
L
L
Sutton
G
G
Wardman
G
G
Patnick
J
J
Winder
R
R
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