Gj. Ong et al., EARLY RESCREEN RECALL IN THE UK NATIONAL-HEALTH-SERVICE BREAST SCREENING-PROGRAM - EPIDEMIOLOGIC DATA/, Journal of medical screening, 5(3), 1998, pp. 146-155
Objective-In the United Kingdom in 1994-95 about 16 500 women aged 50
to 64 were asked to come back earlier than the usual three yearly scre
ening interval for further mammography (early rescreen (ES)) or for a
range of further investigations at an assessment centre (early recall
(ER)). This study aimed at providing epidemiological data on ES/ER, in
particular, how often and why it is used, and what the outcome is of
using it. Setting-National Health Service breast screening programme i
n the United Kingdom. Method-All breast screening units were invited t
o complete a postal questionnaire. Two reminders were sent. The units
were asked retrospectively to provide breast screening data about wome
n aged 50 to 64 from their local computer systems. Women placed on ES/
ER were followed up for at least one year. Results-The response rate w
as 71% (69/97), of which 14% (10/69) were unable to provide the requir
ed data, leaving 59 completed questionnaires (61%). The rate of placin
g women on ES/ER was above 1.0% for 26/54 (48%) responding breast scre
ening units and above 2.0% for 13/54 (24%) units. Women were placed on
ES/ER because of (a) previous breast cancer (21% of cases; cancer det
ection rate 2.4%), (b) diagnostic uncertainty (51%; cancer detection r
ate 3.0%), or (c) family history (27%; cancer detection rate 0.6%). Br
east screening units with a high rate of placing women on ER were sign
ificantly more likely to have a high recall rate (r(s)=0.63; n=53; p<0
.0005) or a high benign surgical biopsy rate (r(s)=0.33; n=49; p<0.05)
, or both. The cancer detection rate of ES/ER tended to decrease with
increasing ES/ER rates (r(s)=-0.37; n=51; p<0.01). Conclusions-A relat
ively large number of women were placed on ES or ER for a range of rea
sons. If the recommendations given are followed, the number of women p
laced on ER may be reduced while maintaining the cancer detection rate
at the required level. The option of ES should not be used.