Cancer Screening Evaluation Unit, Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey, SM2 5NG.
J Med Screen. 2011;18(2):91-5. doi: 10.1258/jms.2011.010134.
The NHS breast screening programme (NHSBSP) in England currently invites women aged 50-70 every three years. Whilst screening is acknowledged as efficacious for women aged 50-69, several countries routinely invite women up to the age of 74. The NHSBSP in England is beginning to invite women up to the age of 73. Although the incidence of breast cancer increases with age, the possible benefits of screening older women must be balanced against shorter life expectancies and possible overdiagnosis. In England women can self-refer after reaching the invitation upper age limit.
We examined the extent to which older women in England self-referred over a three-year period and studied the screening outcomes in these women.
Routinely collected data from screening units in England were used to calculate screening performance measures for women who self-referred between 1 April 2005 and 31 March 2008. The tumour characteristics of all screen-detected cancers were examined by previous screening history and age group (71-74 and ≥75 years).
During the three-year period 139,910 women aged over 70 self-referred; equivalent to 4% of the female population aged over 70 having been screened. The majority of women who self-referred had been screened within the previous five years (76% of those aged 71-74 and 65% of those aged 75 or over). Approximately 4% of these women were recalled for assessment and cancer detection rates were similar in both age groups.
Only a small proportion of all women aged over 70 utilize the self-referral policy of the NHSBSP, and most such women are aged below 80.
英格兰国民保健署（NHS）乳房筛查计划（NHSBSP）目前每三年邀请一次年龄在 50-70 岁的女性。虽然筛查对 50-69 岁的女性是有效的，但一些国家通常会邀请年龄在 74 岁以下的女性。英格兰 NHSBSP 开始邀请年龄在 73 岁以下的女性。尽管乳腺癌的发病率随年龄增长而增加，但必须权衡对年龄较大女性进行筛查的潜在益处与较短的预期寿命和可能的过度诊断。在英格兰，女性在达到邀请的最高年龄限制后可以自行申请。
我们检查了在三年内，英格兰年龄较大的女性自行申请的程度，并研究了这些女性的筛查结果。
使用英格兰筛查单位的常规收集数据，计算了 2005 年 4 月 1 日至 2008 年 3 月 31 日期间自行申请的女性的筛查性能指标。通过之前的筛查史和年龄组（71-74 岁和≥75 岁）检查所有筛查发现的癌症的肿瘤特征。
在三年期间，有 139,910 名年龄在 70 岁以上的女性自行申请；相当于过去五年内筛查的所有 70 岁以上女性的 4%。大多数自行申请的女性在过去五年内接受过筛查（71-74 岁的女性中有 76%，75 岁或以上的女性中有 65%）。这些女性中有大约 4%被召回进行评估，两个年龄组的癌症检出率相似。
只有一小部分所有 70 岁以上的女性利用了 NHSBSP 的自行申请政策，而且大多数这样的女性年龄都在 80 岁以下。
