Breast cancer screening: report to the Health Ministers of England, Wales, Scotland & Northern Ireland
H.M.S.O., 1986 - Medical - 102 pages
The information already available from the principal overseas trials led us to conclude that deaths from breast cancer in women aged 50-64 years who are offered screening by mammography can be reduced by one third or more. Highquality single medio-lateral oblique view mammography has been shown to be an effective method in reducing mortality from breast cancer and we conclude that initially this is the preferred option for the development of mass population screening. The priority of any screening programme should be given to offering an initial screen to as many women as possible aged between 50-64 years. The assessment of screen-detected abnormalities requires specialized techniques. The manpower implications for radiologists and radiographers are critical to the introduction of a screening programme. The estimates for cost per life-year or cost per QALY gained for breast cancer screening are not dissimilar to other health service activities currently undertaken. We estimate that the annual revenue cost to the NHS in the UK for running a screening service is about 18 million pound (1985-86 prices). Determining the optimum interval for screening must have high priority for research.
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Chapter 1 lntroduction
Chapter 2 Principles of screening and their application to breast cancer
21 other sections not shown
acceptance rates age-group Annex assumptions basic screening unit benign breast disease biopsy biopsy rate breast cancer mortality breast cancer screening breast disease breast self-examination cancer detected cent centres Chapter clinical examination control group cost per life-year Cost-Utility Analysis costs and benefits costs of screening Counties Sweden DHSS diagnosis discounted dose equipment estimates Guildford health authorities HlP New York increase initial interval Kopparberg Counties life-year gained mammo mammograms mammographic screening mammography mammography and clinical manpower implications marginal cost mortality from breast Nijmegen non-invited women number of breast number of women offered screening organisation pathologist practitioner present prevalence screen QALY radiographers radiological radiologists radiotherapy Referrals risk factors screen-detected abnormalities screening for breast screening procedure screening programme screening service screening test sensitivity session single-view mammography specialist assessment team stage study group Table techniques treatment two-view UK trial woman women aged 50 workload