National Interval Cancer Reporting (ODR1617_011)

The Cancer Screening Programmes (operated by UKHSA) are required to carry out quality assurance of their screening activities and to evaluate long-term outcomes. The principle investigator and colleagues at the Centre for Cancer Prevention (CCP), part of the Wolfson Institute of Preventive Medicine at QMUL, have been contracted to provide independent evaluation services to fulfil some of these responsibilities.

This project is part of an on-going process to analyse breast interval cancers which are a key indicator of the performance the screening units and of the programme as a whole.

Each year, over 2 million women are screened by the NHS Breast Screening Programme in England. Breast screening saves around 1,300 lives every year by detecting cancer at an early stage when treatment is likely to be more successful. However, no screening programme is 100% accurate. Sometimes cancers are not visible on mammography and others may grow in the time between screening appointments. Occasionally they are missed by the film readers. In England, the Screening Quality Assurance Service, run by Public Health England, is responsible for making sure screening programmes are safe and effective by checking that national standards are met. As part of their work, the Screening Quality Assurance Service looks at interval cancers. Interval cancers are cancers that are diagnosed in between routine screening appointments. Following radiological review, interval cancers are categorised into 3 classifications:

Satisfactory: Newly detectable cancers that could not have been detected at the most recent screen (common).

Satisfactory with learning points: Cancers that were slightly visible at the last screen but not recalled for further tests because the signs of cancer were very subtle and most screeners reporting mammograms would report them as normal (less common).

Unsatisfactory: Cancers that were visible at the last screen but not recalled for further tests because the signs were missed (rare).

This clinical audit will review data collected by the Screening Quality Assurance Service on interval cancers to report on the rates of interval cancers by each screening service. It will also provide additional information that can be used in visits to or discussions with services to help improve the performance of the programme as a whole.

The Inclusion/exclusion criteria for the cohort has been defined as

Inclusion

All women in England arising as interval cancers [ICD codes: C50s and DO5s (invasive and in situ)] whose previous screen was during the 2008/09 screening year.

This will include cancers diagnosed between April 2008 and July 2012, allowing for a period from screening episode to interval cancer presentation up to 40 months.

For purposes of calculating the rates, interval cancers will be counted if presenting within 36 months of a previous screening episode.

The study team team will produce a detailed report of aggregated interval cancer statistics, based on its analysis of the data, and this will be published by the NHS Breast Screening Programme as part of its commitment to continuous improvement and transparency. This will be completed annually.

This project is part of an on-going process to analyse breast interval cancers which are a key indicator of the performance the screening units and of the programme as a whole.

Regular audit of interval breast cancers provides Public Health England with information on the efficiency of the breast cancer screening programme and improves understanding of the natural history and development of breast cancer. This is essential for quality analysis, programme planning, and education of radiologists in screening mammography.

Not stated in the register.