The Breast Screening Programme in England was set up by the NHS in 1988 and covered all women in the country by 1993. As with other NHS services, breast screening is free to women and funded from general taxation. Women aged 50 - 64 are invited, with women aged 65 and over free to have screening at their request.

The NHS Breast Screening Programme is nationally co-ordinated, but locally organised through approximately 86 screening units. There are similar organisations in Scotland, Wales and Northern Ireland covering the rest of the UK. Altogether there are around 100 screening units in the UK.

The Screening Programme in England screens around 1.3 million women per year. A further quarter of a million women are screened the rest of the UK. More than 70% of women in England have now been screened at least once in the previous three years.

Women are invited for screening every three years. A nationally funded study to look at the frequency of screening, recently concluded that there was little to gain from more frequent screening and the three year policy has therefore been confirmed. (European Journal of Cancer 38 (2002) 1458-1464). Initially the programme was based on a single view at all screening rounds, but this has subsequently been amended to two views at the first attendance and now is being extended so that all women receive two views at every attendance. Around two-thirds of films are double read.

Of the women screened 5% were referred for assessment. Of women aged 50, 51 & 52 coming for screening for the first time, about 8.3% of them were recalled for further investigation and of them around 1 in 3 underwent FNA cytology and/or core biopsy. About 1 in 20 were referred for open biopsy. Of women aged 53 to 64 who were attending for a second or subsequent screening episode, 3.9% were recalled for further investigation, with 1 in 4 requiring FNA cytology and/or core biopsy and around 1 in 25 going forward for open biopsy.

A total of 8,345 cancers were diagnosed by the Screening Programme, a rate of 6.4 per thousand women screened. This translates to 6.7 per thousand women screened in the prevalent round and 5.5 per thousand women screened in the incidence round.

Twenty one percent of cancers (1,728) were DCIS or micro-invasive. Forty two per cent of the cancers (3,475) were invasive cancers but smaller than 15mm. Seventy five per cent of the invasive cancers were lymph-node negative. Nineteen per cent (1,615) of cancers were invasive but less than 10mm in size.

The NHS Breast Screening Programme has an extensive quality assurance network, which monitors the performance of all screening units this includes evaluation of all new breast screening equipment. The expansion of breast screening to increase the invitation age range up to and including the age of 70 is now in train and should be complete around 2004.

The Programme operates a website where further information, statistical details and PDFs of documents and leaflets etc can be found.

For more information on screening activities in England you can contact: Julietta Patnick, National Co-ordinator, NHS Cancer Screening Programmes, The Manor House, 260 Ecclesall Road South, Sheffield S11 9PS, Tel: 0114 271 1060, Fax 271 1089