Evaluation of extension of breast screening to women aged 65-70 in England using screening performance measures.

The objective of this study was to investigate screening performance measures in the English screening units that began inviting women aged 65-70 between 1 April 2001 and 1 April 2004. We analysed results after each unit commenced inviting women aged 65-70. In addition, we analysed data from units that invited this age group for a second time between 1 April 2004 and 31 March 2007. Results for women aged 65-70 were compared to women aged 50-64 and 60-64. Average uptake was 72.8% for women aged 65-70 and 76.7% for women aged 50-64. For women screened within the last 5 years, uptake was 88.7% for older women and 89.1% for younger women. For women previously screened within 5 years the invasive cancer detection rate was 17% higher in the 65-70 age group than in the 60-64 age group. The rates of recall to assessment and PPV were 3.5 and 27.6% in women aged 65-70 and 3.4 and 24.6% in women aged 50-64 respectively. These results suggest that, as in the earlier demonstration studies, uptake rates remain high in older women, and many more older women attend following an invitation than had previously self-referred. The cancer detection rate is higher in this older age group, whereas rates of recall are generally similar to those in younger women; consequently the PPV is also higher in older women.