MedWire News: Over 70% of women in England aged 65–70 years will take up an invitation to undergo mammograms, study findings indicate.
The UK National Health Service breast screening programme (NHSBSP) invites women aged 50–64 years to undergo 3-yearly mammograms, with a self-referral system in place for older women, explain Rachel Bennett (Institute of Cancer Research, Sutton, UK) and co-workers.
Following the extension of screening invitations to women aged 65–70 years in some English hospitals between 2001 and 2004, and again between 2004 and 2007, the team examined the findings for these patients.
On average, 72.8% of women aged 65–70 years took up the invitation for screening compared with 76.7% of women aged 50–64 years. Although the rate was lower in the older than younger women, the researchers note that the rate was higher than the 70% target rate.
Screening uptake among women who had been screened in the past 5 years was 88.7% and 89.1% in older and younger women, respectively.
Recall rates after the first round of screening were similar in older and younger patients screened within 5 years, at 3.4% and 3.5%, respectively. However, while the recall rate fell in all patients screened within 5 years to 3.1%, and fell in women aged 50–64 years screened more than 5 years ago, the rate rose in women aged 64–70 years to 5.3%.
“These results suggest that, as in the earlier demonstration studies, uptake rates remain high in older women, and many more older women attend following an invitation than had previously self-referred,” Bennett et al comment.
Invasive cancer was detected in patients aged 65–70 years at an average rate of 7.6 and 12.0 per 1000 women for women screened within past 5 years and those screened at a longer interval, respectively. Both rates were significantly higher than for women aged 60–64 years at 6.5 and 8.9 per 1000 women, respectively.
Thus, the positive predictive value of recall to assessment was significantly higher in women aged 65–70 years than in those aged 60–64 years for women screened in the past 5 years (27.6% vs 24.6%) and those screened at a longer interval (28.3% vs 21.8%).
Noting the recommendation to extend the NHSBSP to women aged 47–-73 years, the team suggests: “Current rates of self-referral in women aged 71–73 should not be used to predict future uptake in this age group.
“The effect on resources of the further extension of the programme is likely to be considerable if uptake for both the 71–73 and 47–49 age groups is similar to the 50–70 age group.”