Routine breast screening for women aged 65-69: results from evaluation of the demonstration sites

Routine programme data and specially designed surveys from 3 demonstration sites were analysed to determine the implications of extending the NHS Brea st Screening Programme (NHSBSP), to include routine invitations for women u p to 69 years. All women aged 65-69 and registered with GPs in these areas received routine invitations for breast screening along with those aged 50- 64. Overall uptake was 71% in women aged 65-69 compared with 78% in younger women, but was greater than or equal to 90% in both groups who had previou sly attended within 5 years. Recall rates were lower for older women, but w ith a higher positive predictive value for cancer. The percentages of invas ive cancer in different prognostic categories were similar in the 2 age gro ups. Older women took no longer to screen than younger women. The costs per woman invited or per woman screened were also similar to those for women a ged 50-64, whilst the cost per cancer detected was some 34% lower in older women. Breast screening is as cost effective for women aged 65-69 as for th ose aged 50-64, with a higher cancer detection rate balancing shorter life expectancy. The proposed extension to the national programme will have cons iderable workforce implications for the NHSBSP and require additional resou rces. (C) 2001 Cancer Research Campaign.