More could have missed UK breast cancer screening than previously thought

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Many more women in the UK could have missed out on breast cancer screening invitations dating back further than previously thought. The Guardian reports that this is according to Professor Peter Sasieni, a cancer screening and prevention researcher at King’s College London. The UK’s Health Secretary, Jeremy Hunt, said earlier this month that women’s lives may have been cut short by an IT error, which meant 450,000 patients in England missed crucial examinations. Up to 270 women may have died because of a computer glitch dating to 2009.

Sasieni believes the problems could have started in 2005 but, the report says, his analysis has been disputed by the government agency Public Health England (PHE), which described it as flawed. Sasieni studied data from the screening programme between 2004 and 2017, looking at the number of eligible women who were sent invitations each year from the ages of 45 to 70. In a letter, Sasieni said the number of invitations sent to women aged 65 to 70 was very low between 2004 and 2005 when the programme was extended to the age of 70.

A third of eligible women should have been invited every year, but Sasieni claimed the figures showed it was 31% in 2005-06, rising to almost 35% in 2016-17. In comparison, 34-38% of women aged between 50 and 64 were invited each year. The difference meant more than 500,000 could have missed out on invitations since 2005, he concluded.

He states in the letter: “Data that might have alerted people to the lower-than-expected number of invitations being sent to women aged 70 were publicly available, but no one looked at them carefully enough.

“Some of the fault lies in the way the data was presented, but it is also unclear whose responsibility it is to monitor such outcomes.”

The report quotes Professor John Newton, director of health improvement at PHE, as saying: “This is a flawed analysis which fails to take into account some important facts, such as when the breast screening programme was rolled out to all 70-year-olds in England or when a clinical trial was started called Age X.”

He said PHE was focused on supporting those not invited to their final screening.

Norman Lamb, the Liberal Democrat MP and former health minister, said that the analysis had to be taken seriously. “Too many people have been left anxious and potentially worse off by a catalogue of failures,” he said. Any analysis brought forward must therefore be taken seriously and considered by the independent review of the NHS breast cancer screening programme.

“To truly restore confidence, however, Liberal Democrats are urging the health secretary to look at a broader review of other population screening programmes.”

The report says the government has ordered an independent inquiry into the scandal, which Hunt said had only been discovered in January after almost a decade of errors. The review, which will report back later this year, aims to establish how many people were affected, why the error occurred and how it could be prevented in future.

Lynda Thomas, the CEO of Macmillan Cancer Support, and Professor Martin Gore, consultant medical oncologist at the Royal Marsden, were named as its heads.

The Guardian report
The Lancet letter

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