title: Should a standard be defined for the Positive Predictive Value (PPV) of recall in the UK NHS Breast Screening Programme?
abstract: The UK NHSBSP defines standards for both cancer detection rate and recall rate for assessment but has not explicitly set a defined standard for positive predictive value (PPV) of recall. However, as PPV is defined as the percentage of women who are recalled and have a final diagnosis of cancer, a standard for PPV is an implicit consequence of the standards for cancer detection rate and recall rate. The standards are defined in terms of a lower level of acceptability known as the 'minimum standard' and a higher level of acceptability referred to as the 'target'. The target can be shown to be a PPV of more than 5.1% for prevalent screens and more than 8.4% for incident screens. This paper will explore the role of PPV as a performance measure and show how making moderate increases in PPV for programmes with the lowest PPVs could lead to major improvements in the overall efficiency of the programme.
authors.affiliation: Cancer Screening Evaluation Unit, Section of Epidemiology, Institute of Cancer Research, Cotswold Road, Sutton, Surrey SM2 5NG, UK. rachel.bennett@icr.ac.uk
authors.forename: R L
authors.initials: RL
authors.lastname: Bennett
authors.forename: R G
authors.initials: RG
authors.lastname: Blanks
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D017598:Efficiency, Organizational; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D011237:Predictive Value of Tests; D015397:Program Evaluation / Q000379:methods*; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation / Q000592:standards*; D018570:Risk Assessment / Q000592:standards*; D013222:State Medicine / Q000592:standards*; D006113:United Kingdom