NHS Breast Screening Programme responds to suggestions that breast screening should start at age 47

Published 18th July, 2003

In a letter by Peter Sasieni and Jack Cuzick from Cancer Research UK published by The Lancet 19 July 2003, the authors contend that, even before the results of the Age trial are available, women should be offered routine breast screening from the age of 47.

Julietta Patnick, Director of NHS Cancer Screening Programmes responds "The NHS Breast Screening Programme has always been based on sound research evidence. We constantly review and examine the appropriateness of screening women under 50. Part of that review is the Age trial which involves 159,000* women over 15 years.

"The World Health Organisation's International Agency for Research on Cancer (IARC) concluded that there is sufficient evidence for the efficacy of breast screening of women between 50 and 69 years. For women aged 40-49 years, the groups concluded there is only limited evidence for a reduction.

"We therefore need to wait for the results of the Age trial to see what benefit, if any, is gained from screening women under 50. In the meantime we are continuing to extend the programme so that by the end of 2004 women up to and including the age of 70 will be invited for screening. This is the biggest expansion to the programme since it was launched. Once completed we should have the results of the Age trial to consider."

"It is also important to remember that the average age of the menopause in the UK is 50. As women go past the menopause, the glandular tissue in their breast involutes and the breast tissue is increasingly only made up of fat. This is clearer on the mammogram and makes interpretation of the x-ray more reliable. Breast cancer is also far more common in post-menopausal women and the risk continues to increase with rising age."

Notes to editors

1. *The Age trial considers what benefit, if any, is gained by screening women under 50. 53,000 women aged 40 and 41 are being invited for annual screening for seven years after which they are automatically invited every three years as part of the NHS Breast Screening Programme. A control group of 106,000 women, who will not be invited for screening but will receive usual NHS care, will be monitored for breast cancer over this period.

2. The NHS Breast Screening Programme is an effective part of the UK's efforts to reduce the death toll from breast cancer. In September 2000, the first research was published which demonstrated that the screening programme has lowered mortality rates from breast cancer in the 55-69 year age group. It is estimated that the programme is on course to save 1,250 lives per year (25 per cent reduction in mortality) by the year 2010.

3. The NHS Breast Screening Programme provides free breast screening every three years for all women in the UK aged 50 and over. Women aged between 50 & 64 are routinely invited for breast screening every three years, and work is being carried out to extend the programme to women up to and including the age of 70 by the end of 2004. Women over 70 are encouraged to make their own appointments.