title: The effects of a UK review of Breast Cancer Screening on Uptake: an observational before/after study.
abstract: OBJECTIVE
  To measure whether uptake of breast cancer screening was affected by the publication of the Marmot Review and associated press coverage.
  
  
  METHODS
  Eight NHS breast screening centres in the West Midlands of the UK.
  
  
  METHODS
  Uptake of breast cancer screening invitations was compared in the week before and after the Marmot review publication. All 12,023 women invited for screening between 23 October 2012 and 5 November 2012 were included. A mixed effects model of the predictors of screening uptake (on date invited, or within 21 days) was created. Predictors considered for inclusion were whether the allocated screening appointment was before or after publication of the review, population factors (age, index of multiple deprivation income domain by quintile, previous attendance), and interaction terms.
  
  
  RESULTS
  Uptake decreased after publication of the review from 65% to 62% (OR = 0.87 95%CI = 0.80-0.94), but a similar decrease was seen for the same dates on the previous year (OR = 0.85 95%CI = 0.78-0.93). Odds of attending screening were lower for women in the most deprived (uptake = 49%, OR = 0.54, 95%CI = 0.46-0.62) in comparison with the least deprived quintile (uptake = 71%). Odds of attendance also increased if the woman had ever previously attended (OR 3.9 95% CI 3.5-4.4), and decreased with each year of increasing age (OR 0.96 95% CI 0.96-0.97). There were no interactions between any of the other predictors and whether the appointment was before or after publication of the Marmot review.
  
  
  CONCLUSIONS
  No change in uptake of breast cancer screening above normal seasonal variation was detected after publication of the Marmot review.
authors.affiliation: NIHR postdoctoral research fellow, Warwick Medical School, The University of Warwick, Coventry, CV4 7AL.
authors.forename: Sian
authors.initials: S
authors.lastname: Taylor-Phillips
authors.forename: Emma
authors.initials: E
authors.lastname: O'Sullivan
authors.forename: Olive
authors.initials: O
authors.lastname: Kearins
authors.forename: Helen
authors.initials: H
authors.lastname: Parsons
authors.forename: Aileen
authors.initials: A
authors.lastname: Clarke
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D006113:United Kingdom