By invitation only - the case for breast cancer screening reminders for women over 69 years.

Carla Saunders,Sally Crossing,Monica Robotin

doi:10.1186/1743-8462-5-23

Abstract

BackgroundBreast cancer is the leading cause of cancer death in women in Australia. Early detection provides the best chance of reducing mortality and morbidity from the disease. Mammographic screening is a population health strategy for the early detection of breast cancer in Australia. Recruitment strategies such as regular advertising and biannual screening invitations are exclusively targeted at women aged 50 – 69 years. Even though they can participate, women 70 years or over are not invited or actively encouraged to undertake screening. Research has found that a routine letter of invitation increases the number of women participating in breast cancer screening.MethodsCancer data analysis and a literature and policy review was conducted to assess age specific breast cancer mortality rates and the legitimacy of rationale used to limit invitations for breast cancer screening to women younger than 70 years.ResultsThe proportion of women over 69 years participating in the BreastScreen program is significantly less than rate of screening in the target age range (50–69 years). Evidence and data indicate that common justifications for limiting screening reminders to the target age range including life expectancy, comorbidities, effectiveness, treatment and cost are, for many women, unreasonable.ConclusionThere is now sufficient data to support a change in the targeted upper age range for breast cancer screening to improve the existing suboptimal surveillance in women aged over 69 years.

Highlights

Breast cancer is the leading cause of cancer death in women in Australia
There has been a slow decline in the number of women older than 69 years participating in the national BreastScreen program over the past decade, with only 11% of women in this age group participating in 2004–5 [3]
This compares very poorly with participation rates of the targeted age range, which have steadily increased over the past decade and currently sit at almost 74% [3]

Summary

Introduction

Breast cancer is the leading cause of cancer death in women in Australia. Early detection provides the best chance of reducing mortality and morbidity from the disease. Mammographic screening is a population health strategy for the early detection of breast cancer in Australia Recruitment strategies such as regular advertising and biannual screening invitations are exclusively targeted at women aged 50 – 69 years. Mammography has been demonstrated to reduce morbidity and mortality from breast cancer [5] through early disease detection, which, when managed effectively, leads to improved survival and less aggressive treatment [3]. At this time, mammography is the only accepted screening modality for breast cancer in average risk populations [6]

Methods

Results

Discussion

Conclusion