Statistical Publication Notice

27 July 2010

Click here for Scottish Breast Screening Programme Statistics 2008/2009

Introduction

The Scottish Breast Screening Programme is part of a UK-wide programme of free mammographic screening for breast cancer, which was set up in 1988 with the aim of reducing mortality. In 2008, the NHS Breast Screening Programme in Scotland celebrated its 20th Anniversary. Since full national coverage was attained in 1991 there have been over 2.3 million screening episodes and approximately 17,000 breast cancers diagnosed.

In Scotland, women aged 50-64 years were invited for a routine screen once every three years until 2003-04, when the age range for invitation was extended to include women up to the age of 70 years.  This expansion was phased in throughout the country over a three year round of screening. 

Up until 2007/08, the screening method used in Scotland consisted of two mammographic views at first screen and one view at subsequent screens. In Better Cancer Care, An Action Plan the Scottish Government affirmed its commitment to the implementation of two view screening at every screening appointment by April 2010. In 2008/09 a phased roll out of two views commenced and was completed in March 2010. 

Within Scotland (as part of the Scottish Breast Screening Programme) information and performance data are compiled by ISD on an annual basis. The NHSBSP Performance Standards, which minimum and target standards are specified, are the means by which this information is evaluated. Up until 31st March 2008, the NHSBSP Performance Standards were based on women aged 50-64; to reflect the expansion of the age range, they have now been extended to include women up to the age of 70 in this publication. The present release includes data to 31st March 2009. Previously published trends in NHSBSP Performance Standards to 31st March 2008, for women aged 50-64, are available in the ‘Tables and Charts’ section of the Breast Screening pages.

Key Points

In 2008-09, approximately 1,500 cases of screen detected breast cancer were diagnosed in women of all ages.

NHSBSP Performance Standards, at 31st March 2009:

• Looking at three year performance standard attendance figures, uptake remains similar to last year, at approximately 75%.
• All NHS Boards continued to exceed the minimum performance attendance standard of >70% of women invited during the previous three years.
• Looking at three year combined data, uptake fell with increasing deprivation from approximately 82% in the least deprived category to 64% in the most deprived category. Women in the most deprived quintile failed to meet the minimum performance standard of 70%.
• Comparing three year combined performance figures for those women with a previous screen within 5 years of last attendance, the invasive cancer detection rate has increased from 5.7 to 6.0 per 1,000 women screened in 2006-2009.
• In 2008/09, 10 of 11 NHSBSP (NHS Breast Screening Programme) Minimum Performance Standards were met.

Detailed Findings

The NHSBSP Performance Standards were previously based on women aged 50-64; to reflect the expansion of the age range, they have now been extended to include women up to the age of 70 in this publication.

Women are invited to attend screening once every three years. Looking at three year rolling performance standard attendance figures, uptake remains similar to last year, at approximately 75%. This exceeds the minimum standard of >70%.

All NHS Boards continued to exceed the minimum performance attendance standard of >70% of women invited during the previous three years. The highest uptake was found in Shetland, with an attendance rate of 87%.

Looking at three year combined data to March 2009, uptake fell with increasing deprivation from approximately 82% in the least deprived category to 64% in the most deprived category. Women in the most deprived quintile failed to meet the minimum performance standard of 70%. There is a characteristic pattern associated with deprivation and uptake of screening. Individuals living in the least deprived quintile are more likely to accept an invitation to screening compared to those living in the most deprived quintile.

Comparing three year combined performance figures for those women with a previous screen within 5 years of last attendance, the invasive cancer detection rate has increased from 5.7 to 6.0 per 1,000 women screened in 2006-2009.

In 2008-09, ten of the eleven NHSBSP (NHS Breast Screening Programme) Performance Standards were achieved which included uptake, cancer detection and early recall rates. However, the rate of recall for assessment of women screened in response to their first invitation, at 10.2%, narrowly failed to meet the minimum standard (below 10%). This measure indicates the proportion of women who are sent for further investigation, many of whom are not subsequently diagnosed with cancer.

In the last 5 years, the number of screen detected breast cancers per year has increased by over 300, from 1,164 to 1,488. This increase may be due, at least in part, to a phased extension of the age range for routine invitation (from 50-64 to 50-70 years), which started in 2003.

In 2008-09, approximately 1,200 invasive cancers were detected in women of all ages, of which approximately half were less than 15mm in size. These small cancers are unlikely to have been detected by palpation, highlighting the importance of screening in the early detection of breast cancer.

The proportion of cancers diagnosed pre-operatively has increased by almost 30% since 1997. Due to the development of radiological biopsy techniques over this time period, 96.3% of women screened who have a breast cancer were diagnosed by radiological biopsy within the screening centre, rather than requiring diagnostic surgery. Therefore the number of women requiring two operations, diagnostic as well as therapeutic, has been significantly reduced.

Main Contacts

Donna Nicholson
Senior Statistician
0141 282 2083
donna.nicholson@nhs.net

Glossary

For the purpose of this publication ‘uptake’ and ‘attendance’ are synonymous.

Pre-Release Access

Under terms of the "Pre-Release Access to Official Statistics (Scotland) Order 2008", ISD are obliged to publish information on those receiving Pre-Release Access ("Pre-Release Access" refers to statistics in their final form prior to publication). The standard maximum Pre-Release Access is five working days. Shown below are details of those receiving standard Pre-Release Access and, separately, those receiving extended Pre-Release Access.

Standard Pre-Release Access

Scottish Government Health Department (Analytical Services Division)
NHS Board Chief Executives
NHS Board Communication leads
Scottish Breast Screening Programme Clinical Directors and Programme Managers
NHS Board Screening Coordinators
Scottish Breast Screening Programme National Co-ordinator and Programme Manager - National Services Division

Extended Pre-Release Access

Scottish Government Health Department (Analytical Services Division)
This extended Pre-Release Access is given to a small number of named individuals in the Scottish Government Health Department (Analytical Services Division). This Pre-Release Access is for the sole purpose of enabling that department to gain an understanding of the statistics prior to briefing others in Scottish Government (during the period of standard Pre-Release Access). 

History of this Publication

Last Published: 28 July 2009
Next Due: July 2011
Data Available Since: Uptake by deprivation category (50 to 64 years) is reported from 1990.
Uptake by NHS Board (50 to 64 years) and Attendance by appointment type are reported from 1991.