Risk-based breast cancer screening program finds significant success

As researchers and advocates in the United States debate the merits of risk-based breast cancer screening vs. age-based screening, a risk-based program in Northern Ireland (NI) has found significant success. A new study published in Clinical Radiology examined the program in detail.

The program began in April 2013 at the urging of the chief medical officer for NI. A multidisciplinary working group was established to work out the details and get providers throughout the area on the same page, and the researchers examined four years of data for their study.

While 235 women were invited to participate in the screening program in 2013-2014, 162 women attended—a rate of 68.9%. The number of women who attended increased each year covered by the study, though the attendance rate did drop from 2014-2015 before jumping back up. By 2016-2017, the risk-based program had 372 participants and an attendance rate of 77.7%.

“The steady rise in attendance in the last 3 years suggests acceptance for screening in this population,” wrote E. Gibson, Antrim Area Hospital in the UK, and colleagues. “With further increased awareness and educational programs, it is thought that 80% attendance is achievable in this screening group.”

How impressive would that number me? For context, NI’s general screening program had an attendance rate of 77.1% in 2016-2017.

The authors also noted that the risk-based program saw recall rates improve each year. The recall rate was 14.2% in 2013-2014, for instance, but it was 8.6% by 2016-2017. The cancer yield, meanwhile, was 25.3 per 1,000 screened women. Cancer detection rates (CDRs) have ranged from 21.5 to 30.9 per 1,000 screened women.

“In conclusion, the Higher Risk Screening Programme in NI has been implemented successfully with increasing identification of eligible women, increasing uptake, acceptable recall rates, and high cancer yield,” the authors wrote. “The data discussed may form the basis for development of targets in this screening program.”