An analysis of 11.3 million screening tests examining the association between needle biopsy rates and cancer detection rates in the English NHS Breast Cancer Screening Programme

Clinical Radiology
R G BlanksM G Wallis

Abstract

To examine the association between recall, needle biopsy, and cancer detection rates to inform the setting of target ranges to optimise the benefit to harm ratio of breast screening programmes. Annual screening programme information from 2009/10 to 2015/16 for the 80 screening units of the English National Health Service Breast Screening Programme (totalling 11.3 million screening tests) was obtained from annual (KC62) returns. Linear regression models were used to examine the association between needle biopsy rates and recall rates and non-linear regression models to examine the association between cancer detection rates and needle biopsy rates. The models show and quantify the diminishing returns for prevalent screens with increasing biopsy rates. A biopsy rate increase from 10 to 20 per 1,000 increases the cancer detection rate by 2.13 per 1,000 with four extra biopsies per extra cancer detected. Increasing the biopsy rate from 40 to 50 per 1,000, increases the cancer detection rate by only 0.25 per 1,000, with 40 extra biopsies per extra cancer detected. Although diminishing returns are also seen at incident screens, screening is generally more efficient. Increasing needle biopsy rates leads to rapidly diminishing returns i...Continue Reading

References

Jun 8, 2013·British Journal of Cancer·M G MarmotM Wilcox
Jul 23, 2013·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Paula A van LuijtUNKNOWN National Evaluation Team for Breast Cancer Screening in Netherlands Study Group (NETB)
Feb 18, 2015·The Breast : Official Journal of the European Society of Mastology·Oliver HeidingerHans-Werner Hense
Jan 29, 2017·BMJ : British Medical Journal·Muir Gray
Jul 15, 2017·The British Journal of Radiology·Rosalind Given-Wilson
Dec 12, 2017·Clinical Radiology·W B G Sanderink, R M Mann

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