Mammography screening in the USA has higher recall rates and lower cancer detection rates than in the UK

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Question Do mammography screening programmes in the UK and USA generate different recall and cancer detection rates? Study design Outcomes analysis, international screening programme comparison. Main results The incidence of breast cancers among women in the US and UK programmes was comparable. In all age groups, recall rates were significantly higher in both USA screening programmes for first and subsequent screens compared with the UK programme (see Table 1). Total cancers detected per 1000 were significantly higher in the UK in all age groups (see Table 2). In situ and invasive cancer detection rates were similar between programmes for first screen mammograms. In situ cancer detection rates were similar between programmes for subsequent screening mammograms. Table 1 Recall rate, % (95% CI) by screening programme. BCSC (USA) NBCCEDP (USA) NHSBSP (UK) First screen 13.1% (12.8 to 13.4) 11.2% (11.1 to 11.4) 7.4% (7.0 to 7.3) Subsequent screen 8.0% (7.9 to 8.1) 6.8% (6.8 to 6.9) 3.6% (3.6 to 3.7) Table 2 Total cancer detection rate, rate per 1000 (95% CI) by screening programme. BCSC (USA) NBCCEDP (USA) NHSBSP (UK) First screen 8.6 (7.9 to 9.4) 8.3 (7.7 to 8.7) 10.1 (9.4 to 10.7) Subsequent screen 3.6 (3.5 to 3.7) 3.4 (3.3 to 3.6) 5.4 (5.2 to 5.5) Authors’ conclusions Mammography screening programmes in the USA generate recall rates, which are significantly higher than in the UK while total cancer detection rates were significantly lower.