Breast Screening Programme, England:

Transcription

1 Breast Screening Programme, England: KEY FACTS At 31 March % of women aged resident in England had been screened at least once in the previous 3 years (74.9% at 31 March 2004). In 244 of the 303 Primary Care Organisations the coverage was 70% or higher (247 in 2004). In million women of all ages were screened within the programme. Over 11,960 cases of cancer were diagnosed in women of all ages screened, of which 8,570 were diagnosed in women aged Breast screening: coverage for women and 65-70, England 2002 to 2005 Contents Page % Coverage Introduction 3 Analysis and Commentary - 3 Definitions 5 Editorial notes 6 Index to tables Source: KC63 As at 31 March Reference tables 8 Community Health Statistics Published by the Health and Social Care Information Centre Part of the Government Statistical Service Price: Free ISBN: Bulletin: 2006/02/HSCIC This publication may be requested in large print or other formats. For further information contact: online: telephone: enquiries@ic.nhs.uk 2006, NHS Health and Social Care Information Centre, Community Health Statistics. All rights reserved. This work remains the sole and exclusive use of the Health and Social Care Information Centre, and may only be reproduced, and publicly displayed, where there is explicit reference to the ownership of the Health and Social Care Information Centre. This work may only be reproduced in a modified format with the express written permission of the Health and Social Care Information Centre.

2 Figure 1 Breast screening: Coverage of women aged 53-64, by Primary Care Organisation, England Coverage by PCO, % and over (244) 60% to 69.9% (36) 50% to 59.9% (18) under 50% (5) Source:KC63 2 Statistical Bulletin 2006/02 February 2006

3 1 INTRODUCTION 1.1 The information in this publication, about the breast cancer screening programme in England, is collected on two Health and Social Care Information Centre returns (formerly Department of Health returns). Screening units report the process and outcomes of the call and recall system on return KC62; and Primary Care Organisations report the population coverage of the programme on return KC This is the 11th bulletin to be published on breast cancer screening including data from both the KC62 and KC63 returns. Annual summaries of information from the KC62 were produced from to KC63 returns were received for all of the 303 Primary Care Organisations (PCOs). KC62 returns were received from all 85 screening units. 2 ANALYSIS AND COMMENTARY 2.1 Overview (Table 1) Nearly 1.55 million women aged were invited for screening in , 26% more than in Over the same period, the increase in the population of women in this age group was about 18%. Uptake for this age group has fluctuated between 77% and 75% with Figure 2 the figures showing a very gradual decline since Cancer was detected through the screening programme in 8,570 women aged in , about 75% more than in Coverage (Tables 2 & 11) Coverage of the screening programme is best assessed using the age group as women may be first called at any time between their 50 th and 53 rd birthdays. The reported coverage by the screening programme at 31 March 2005 of women aged was 75.5%. Coverage was substantially lower in London (64%) than in other regions, where the coverage was in the range 73% - 81%. At PCO level, four fifths of PCOs (244 out of 303) reported coverage higher than 70% and just over one in eight (36) reported coverage between 60% and 70%. In Breast screening programme : uptake for women aged by Breast Screening Unit, England, Minimum standard Breast screening unit % uptake (units in the London region shown shaded) Source: KC62 Part 1, Tables A, B, C1 and C2 only 5 of the 303 PCOs was coverage below 50%; 2 of these were in the South West region, 1 in the London region, 1 in the East and 1 in the South East (Figure 1). 2.3 Uptake of invitations for screening (Tables 3, 4, 5, 12 & 13) Nearly 1.55 million women aged were invited for screening in For about 19% this was their first ever invitation; for about 11% it was a second or subsequent invitation to women who had not previously attended for screening and for about 63% it was a routine recall. The remaining women had previously attended, but more than 5 years ago. About 0.1% of invitations were early recalls, women whose previous screening outcome had indicated that monitoring more frequently than the routine 3-year screening interval was desirable. Statistical Bulletin 2006/02 February

4 2.3.2 Overall, 75.0% of women aged invited in were screened. Data relating to short-term recalls have been omitted from the uptake calculation in this publication. These women are excluded as they are not invited to the screening clinic (objective 1 Monitoring National Standards Publication 60, Consolidated Guidance on Standards for the NHS Breast Screening Programme). Table 12 reflects this change and historic data have been revised accordingly though, as the number of cases involved is small, the changes in uptake rates are only minor. Of the 85 screening units, 15 recorded uptake rates of 80% or over and a further 58 recorded rates between 70% and 80%. Uptake rates below 70% were recorded by 12 units, 6 of which were in the London region (Figure 2) Uptake rates varied considerably according to the type of invitation. About 71% of women receiving their first invitation in were screened; and about 88% of women who had already been screened in a previous round and received a routine invitation to be screened again were screened. Of women who received a routine invitation, having failed to respond to a previous invitation, as many as 21% responded and were screened. 2.4 Outcome of screening (Tables 6 & 7) Nearly 1.5 million women were screened in The vast majority were women aged screened following an invitation. In addition, some 107,000 women of all ages were screened following self-referral or referral by a GP. Of the total number screened, about 2% were aged between 45 and 49 and a further 17% were aged 65 or over (including both Figure 3 Breast screening: cancer detection rate, by age, England Rate per 1,000 women screened Over 70 Source: KC62 Part 3 Table T Age those invited and those referred) Of all the women screened, nearly 5% were referred for assessment; but the rates for women attending for the first time (in the prevalent round) and those attending who had been previously screened (in the incident round) were markedly different. About 8.2% of women in the prevalent round were referred for assessment, compared with only 3.6% of women in the incident round. Of women referred for assessment, whether in the prevalent round or the incident round, over a third underwent cytology and/or core biopsy; about 1 in 30 were referred for open biopsy; and about 1 in 30 of the women referred for assessment were recommended for early recall. Of women screened and referred for assessment following a previous recommendation for early recall, nearly 6% were again recommended for early recall. 2.5 Cancers detected (Tables 8, 9 & 10) A total of 11,966 cancers from women of all ages (including invasive and in situ) were detected by the screening programme in , a rate of 8.1 per 1,000 women screened. The overall rate was higher than that in (7.9). In the incident round the rate increased slightly from Statistical Bulletin 2006/02 February 2006

5 to 7.1 cases per 1000 women screened, in the prevalent round the rate also increased slightly from 7.0 to 7.2. It is known that the incidence of breast cancer rises with age and this pattern was observed with cancers detected by the screening programme. The detection rate was nearly 6 (5.7) per 1,000 for women aged 53-54, rising to about 12 per 1,000 women aged (Figure 3) The cancer detection rate varied by type of invitation as well as by age. The quite different age structure of women in the different invitation type groups makes direct comparison difficult. As in previous years the detection rate was high for women screened after early recall, regardless of age. In general where the number of cases was sufficiently large for analysis, detection rates in the incident round for women having their second or subsequent routine screen (within 5 years of a previous screen) were the lowest and the detection rates for previous nonattenders were the highest (Table A) Of all the cancers detected 2,364 (20%) were non-invasive or microinvasive and a further 4,994 (42%) were invasive, but small i.e. less than 15mm. In women 50-64, the proportion of noninvasive and micro-invasive was lowest in the incident round, at 20%, compared Table A Breast screening programme : cancer detection rate by age and type of invitation, England with 26% in the prevalent round. Small cancers accounted for about half of all invasive cancers found in the prevalent and incident rounds. 2.6 Selected Diagnostic and outcome statistics (Table 14 and 14a) As in the previous bulletin, data are presented giving information about the diagnostic process and outcomes of each local screening programme. The screening programmes vary enormously in size, with the smallest screening under 5,000 women per year and the largest over 30,000. Rates for smaller units, particularly for the prevalent round, which accounts for only one quarter of women screened, are often based on very small numbers of cases. Such rates may be subject to considerable fluctuation from year to year and caution should be exercised in interpreting some of the data. 3 DEFINITIONS rate per 1000 women screened All ages Over Type of invitation 45 and over Total st invitation for routine screening (0) Routine invitation to previous non-attenders (0) Routine invitation to previous attenders 7 (1) (12) (Last screen within 5 years) Routine invitation to previous attenders (17) (Last screen more than 5 years previously) Early recalls 36. (21) (48) (40) (43) (67) Self / GP referral (no previous screen) 14 (11) 8 9 (14) (19) 26 Self / GP referral (within 5 yrs) Self / GP referral (> 5 yrs) 19. (14) (3) (16) Source: KC62 Part 1 and 3 Tables A - F2 Rates shown in brackets are based on fewer than 2000 women screened. A small number of women recorded in these categories may have been participating in trial schemes 3.1 The coverage of the screening programme is the proportion of women resident (excluding those ineligible eg those who have had a bilateral mastectomy) who have had a test with a recorded result at least once in the previous 3 years. 3.2 The uptake of the screening programme is the proportion of women invited for screening for whom a screening test result is recorded. Statistical Bulletin 2006/02 February

6 3.3 Prevalent screening is that of women being screened for the first time within the breast screening programme. 3.4 Incident screening is that of women previously screened within the breast screening programme. 3.5 The extension to the breast screening programme to include inviting women aged as routine, commenced in April By the end of , over 90% of local breast screening units were inviting the older women. Full national coverage is expected to be completed by March The data include also some women aged The vast majority of these are women aged 49 who have been called for their first routine screening a few months early, but some were participants in the trial for screening women under EDITORIAL NOTES In the Tables:.. = not available. = not applicable - = zero Media enquiries should be made to: The Health and Social Care Information Centre media office on or media@ic.nhs.uk Any enquiries about data contained in this bulletin, requests for further information, or further copies of this bulletin should be addressed to: The Health and Social Care Information Centre 1 Trevelyan Square, Boar Lane, Leeds, LS1 6AE Tel: enquiries@ic.nhs.uk This bulletin and copies of the KC62 and KC63 returns can be found on the Health and Social Care Information Centre website at: rstscrnprogeng2005 Previous editions of the bulletin can be accessed via the Department of Health website, by clicking on the following links: >Publications and Statistics >Statistics (from shortcuts menu) >Statistical Work Areas >Health Care >Community Care February Statistical Bulletin 2006/02 February 2006

7 INDEX TO TABLES Table Page number Description number Table 1 Summary statistics on breast cancer and the NHS Breast Screening Programme 1995 to Table 2 Test status and coverage of women by age, 31 March Table 2a Test status and coverage of women aged by Government Office Region, 31 March Table 2b Test status and coverage of women aged by Strategic Health Authority, 31 March Table 3 Table 3a Table 4 Estimated uptake of invitations to screen by women aged by Government Office Region, to Estimated uptake of invitations to screen by women aged by type of invitation and region, Number of women invited and estimated uptake of invitations to screen by age and type of invitation, Table 5 Number of women screened by age and type of invitation, Table 6 Women aged 45 and over screened by type of invitation and outcome, Table 6a Women aged screened by type of invitation and outcome, Table 7 Women screened by age, Government Office Region and outcome, Table 7a Women screened by age and outcome, Table 7b Women aged screened by Strategic Health Authority and outcome, Table 8 Women aged 45 and over screened and cancers detected by type of invitation, Table 8a Women aged screened and cancers detected by type of invitation, Table 9 Women screened and cancers detected by age and Government Office Region, Table 9a Women screened and cancers detected by age, Table 9b Women aged screened and cancers detected by Strategic Health Authority, Table 10 Women aged 45 and over, with cancer diagnosed, by size of cancer and age, Table 10a Women aged 50-64, with cancer diagnosed, by invitation type and size of cancer, Table 11 Coverage of women aged by Primary Care Organisation at 31 March, 2002, 2003, 2004 and Table 12 Estimated uptake by women aged of invitations to screen, by unit, to Table 13 Estimated uptake of invitations to screen, by women aged by type of invitation and unit, Table 14 Selected diagnostic and outcome statistics for women aged by unit, Table 14a Selected diagnostic and outcome statistics for women aged by unit, Statistical Bulletin 2006/02 February

8 Table 1 Summary statistics on breast cancer and the NHS breast screening programme, 1995 to 2005 England units Breast Screening programme data Coverage (1) Women aged % Women aged % Women aged % Uptake (2) Women aged % Women aged % Invitations and outcomes (2) Women invited (50-64) millions Women invited (65-70) millions Women screened (50-64) millions Women screened (65-70) millions Women screened (all ages) millions Women referred for assessment (50-64) thousands Women referred for assessment (65-70) thousands Women referred for assessment (all ages) thousands Women with cancer detected (50-64) thousands Women with cancer detected (65-70) thousands Women with cancer detected (all ages) thousands Breast Cancer registration data (3) Registrations in women aged thousands Registrations in women of all ages thousands Registrations per 100,000 popn (50-64) rate Registrations per 100,000 popn (all ages) rate Breast Cancer mortality data (3) Deaths (50-64) thousands Deaths (all ages) thousands Deaths per 100,000 popn (50-64) rate Deaths per 100,000 popn (all ages) rate (1) Source: Form KC63; data are as at 31 March (2) Source: Form KC62; data are for 12 months ending 31 March 2006, Re-used with the permission of The Department of Health. (3) Source: National Cancer Intelligence Centre, ONS; data are for year commencing 1 January Registration and death rates are Directly Age Standardised Rates using the European Standard Population (DAS(E)).. Information not available 2006, Re-used with the permission of The Office for National Statistics

9 Table 2 Breast screening programme : test status and coverage of women by age, 31 March 2005 England thousands Women never Coverage screened Number of (less than 3 Number of women less years since women Number than 3 years last test) Age at test resident ineligible number % since last test (%) , , , , , , , , , , , and over 2, , Source : KC63 Table 2a Breast screening programme : test status and coverage of women aged by region, 31 March 2005 thousands Women never Coverage screened Number of (less than 3 Number of women less years since Government Office women Number than 3 years last test) Region resident ineligible number % since last test (%) England 3, , North East North West Yorkshire & Humber East Midlands West Midlands East London South East South West Source : KC63

10 Table 2b Breast screening programme : test status and coverage of women aged by Strategic Health Authority, 31 March 2005 thousands Women never Coverage screened Number of (less than 3 Number of women less years since women Number than 3 years last test) Strategic Health Authority resident ineligible number % since last test (%) England 3, , County Durham & Tees Valley Northumberland, Tyne & Wear Cheshire & Merseyside Cumbria & Lancashire Greater Manchester North & East Yorkshire & Northern Lincolnshire South Yorkshire West Yorkshire Leicestershire, Northamptonshire & Rutland Trent Birmingham and the Black Country Shropshire & Staffordshire West Midlands South Bedfordshire & Hertfordshire Essex Norfolk, Suffolk & Cambridgeshire North Central London North East London North West London South East London South West London Hampshire & Isle of Wight Kent & Medway Surrey & Sussex Thames Valley Avon, Gloucestershire & Wiltshire Somerset & Dorset South West Peninsula Source : KC63

11 Table 3 Breast screening programme : estimated uptake of invitations to screen (1) by women aged by region, to percentages Government Office Region England North East North West Yorkshire & Humber East Midlands West Midlands East London South East South West Source : KC62 (Part 1, Tables A, B, C1 and C2) (1) First invitations and routine invitations (see para 2.3.2) 2006, Re-used with the permission of The Department of Health. Table 3a Breast screening programme : estimated uptake of invitations to screen by women aged by type of invitation and region, percentages Invitation type Invitation type grouping Routine Routine (1) First invitation Routine invitation Early First & routine First & all Government Office invitation for (previous invitation (more than recall invitation routine Region screening non-attender) (within 5 yrs) 5 yrs) invitations (within 5 yrs) invitations England North East North West Yorkshire & Humber East Midlands West Midlands East London South East South West Source : Form KC62 (Part 1, Tables A to D) (1) This is the grouping used in Table 3 above

12 Table 4 Breast screening programme: number of women invited and estimated uptake of invitations to screen, by age and type of invitation, England Age All ages Age Group Type of Invitation 45 & over Over 70 Invitations (numbers) Total number of women invited 1,841,166 1,547,620 44, , , , , ,236 1,089 1st invitation for routine screening 339, ,426 41, ,354 12,503 12,523 8,046 4, Routine invitation to previous 195, , ,541 41,443 72,084 43,374 25, non-attenders Routine invitation to previous attenders 1,107, ,888 1,904 41, , , , , (Last screen within 5 years) Routine invitation to previous attenders 196, , ,247 4,460 49,486 51,528 85, (Last screen more than 5 years previously) Early recalls 2,593 2, Uptake (percentage screened of women invited) Total st invitation for routine screening Routine invitation to previous non-attenders Routine invitation to previous attenders (Last screen within 5 years) Routine invitation to previous attenders (Last screen more than 5 years previously) Early recalls Source : KC62 (Part 1, Tables A to D) Table 5 Breast screening programme : number of women screened by age and type of invitation, England thousands Age All ages Age Group 45 & over Type of invitation screened screened Over 70 Total 1, , st invitation for routine screening Routine invitation to previous non-attenders Routine invitation to previous attenders (Last screen within 5 years) Routine invitation to previous attenders (Last screen more than 5 years previously) Early recalls Self / GP referral (no previous screen) Self / GP referral (within 5 yrs) Self / GP referral (> 5 yrs) Source : KC62 (Part 1, Tables A to F2)

13 Table 6 Breast screening programme : women aged 45 and over screened by type of invitation and outcome, England Referred (1) Referred (2) Referred Number for assessment for cytology for open Early Recall (3) of and/or core biopsy women biopsy Type of invitation screened (number) % (number) (number) (number) % Total 1,477,844 71, ,049 2,446 2, st invitation for routine screening 239,529 19, , Routine invitation to previous non-attenders 37,446 3, , Routine invitation to previous attenders 976,077 34, ,157 1, (Last screen within 5 years) Routine invitation to previous attenders 115,043 6, , (Last screen more than 5 years previously) Early recalls 2,526 2, Self / GP referral (no previous screen) 15,743 1, Self / GP referral (within 5 yrs) 72,338 3, , Self / GP referral (> 5 yrs) 19,142 1, Source : KC62 (Parts 1 and 2, Tables A to F2) (1) Including women referred for cytology, core biopsy or open biopsy (2) Including women referred for open biopsy (3) Including all women whose final outcome was early recall, whether after initial screen, assessment, cytology or biopsy (core or open) Table 6a Breast screening programme : women aged screened by type of invitation and outcome, England Referred (1) Referred (2) Referred Number for assessment for cytology for open Early Recall (3) of and/or core biopsy women biopsy Type of invitation screened (number) % (number) (number) (number) % Total 1,187,387 56, ,779 1,965 1, st invitation for routine screening 207,873 17, , Routine invitation to previous non-attenders 35,122 2, , Routine invitation to previous attenders 858,277 30, ,238 1, (Last screen within 5 years) Routine invitation to previous attenders 57,721 3, , (Last screen more than 5 years previously) Early recalls 2,088 1, Self / GP referral (no previous screen) 10, Self / GP referral (within 5 yrs) 13, Self / GP referral (> 5 yrs) 1, Source : KC62 (Parts 1 and 2, Tables A to F2) (1) Including women referred for cytology, core biopsy or open biopsy (2) Including women referred for open biopsy (3) Including all women whose final outcome was early recall, whether after initial screen, assessment, cytology or biopsy (core or open)

14 Table 7 Breast screening programme : women screened by age, region and outcome, England Referred (1) Referred (2) Referred Number for assessment for cytology for open Early Recall (3) of and/or core biopsy women biopsy Age Regional Office area screened (number) % (number) (number) (number) % 45 & over England 1,477,844 71, ,049 2,446 2, North East 90,786 3, , North West 202,978 9, , Yorkshire & Humber 152,419 6, , East Midlands 132,711 6, , West Midlands 165,187 7, , East 168,388 8, , London 152,706 7, , South East 257,405 12, , South West 155,264 9, , England 1,187,387 56, ,779 1,965 1, North East 68,540 2, , North West 161,819 7, , Yorkshire & Humber 124,555 5, , East Midlands 105,020 4, , West Midlands 134,215 5, , East 128,211 6, , London 127,853 6, , South East 210,932 10, , South West 126,242 7, , Source :KC62 (Parts 1 and 2, Table T) (1) (2) (3) Including women subsequently referred for cytology, core biopsy or open biopsy Including women subsequently referred for open biopsy Including all women whose final outcome was early recall, whether after initial screen, assessment, cytology or biopsy (core or open) Table 7a Breast screening programme : women screened by age and outcome, England Referred (1) Referred (2) Referred Number for assessment for cytology for open Early Recall (3) of and/or core biopsy women biopsy Age screened (number) % (number) (number) (number) % Total 1,477,844 71, ,049 2,446 2, ,187,387 56, ,779 1,965 1, ,623 2, ,604 18, , ,027 7, , ,225 16, , ,531 13, , ,783 9, , Over 70 38,051 2, Source : KC62 (Parts 1 and 2, Table T) (1) (2) (3) Including women subsequently referred for cytology, core biopsy or open biopsy Including women subsequently referred for open biopsy Including all women whose final outcome was early recall, whether after initial screen, assessment, cytology or biopsy (core or open)

15 Table 7b Breast screening programme : women aged screened by Strategic Health Authority and outcome, England Referred (1) Referred (2) Referred Number for assessment for cytology for open Early Recall (3) of and/or core biopsy women biopsy Strategic Health Authority screened (number) % (number) (number) (number) % England 1,187,387 56, ,779 1,965 1, County Durham & Tees Valley 24, Northumberland, Tyne & Wear 44,091 1, Cheshire & Merseyside 67,188 3, , Cumbria & Lancashire 39,995 1, Greater Manchester 54,636 2, North & East Yorkshire & Northern Lincolnshire 40,944 1, South Yorkshire 37,785 1, West Yorkshire 45,826 2, , Leicestershire, Northamptonshire & Rutland 41,922 2, Trent 63,098 2, , Birmingham and the Black Country 44,423 2, Shropshire & Staffordshire 41,606 1, West Midlands South 48,186 1, Bedfordshire & Hertfordshire 28,916 1, Essex 39,663 1, Norfolk, Suffolk & Cambridgeshire 59,632 3, , North Central London 28,851 1, North East London 24,796 1, North West London 21,997 1, South East London 26,741 1, South West London 25,468 1, Hampshire & Isle of Wight 42,579 2, Kent & Medway 40,650 2, Surrey & Sussex 71,326 3, , Thames Valley 56,377 2, Avon, Gloucestershire & Wiltshire 47,591 2, Somerset & Dorset 33,250 2, South West Peninsula 45,401 2, , Source : KC62 (Parts 1 and 2, Table T) (1) Including women subsequently referred for cytology, core biopsy or open biopsy (2) Including women subsequently referred for open biopsy (3) Including all women whose final outcome was early recall, whether after initial screen, assessment, cytology or biopsy (core or open)

16 Table8 Breast screening programme : women aged 45 and over screened and cancers detected by type of invitation, England Cancers detected Number Rate per 1,000 women screened Number of Total Non - invasive Non - invasive women number of or or screened women with micro - Small micro - Small Type of invitation (thousands) cancer invasive (<15mm) Total invasive (<15mm) Total 1, ,966 2,527 4, st invitation , st screen - previous non responder Routine rescreen (within 5 yrs) ,954 1,422 3, Routine rescreen (>5 yrs) , Early recall Self / GP referral (no previous screen) Self / GP referral (within 5 yrs) Self / GP referral (>5 yrs) Source : KC62 (Parts 1 and 3, Tables A to F2) Table 8a Breast screening programme : women aged screened and cancers detected by type of invitation, England Cancers detected Number Rate per 1,000 women screened Number of Total Non - invasive Non - invasive women number of or or screened women with micro - Small micro - Small Type of invitation (thousands) cancer invasive (<15mm) Total invasive (<15mm) Total 1, ,572 1,898 3, st invitation , st screen - previous non responder Routine rescreen (within 5 yrs) ,816 1,224 2, Routine rescreen (>5 yrs) Early recall Self / GP referral (no previous screen) Self / GP referral (within 5 yrs) Self / GP referral (>5 yrs) Source : KC62 (Parts 1 and 3, Tables A to F2)

17 Table 9 Breast screening programme : women screened and cancers detected by age and region, Cancers detected Number Rate per 1,000 women screened Number of Total Non - invasive Non - invasive women number of or or screened women with micro - Small micro - Small Age Regional Office area (thousands) cancer invasive (<15mm) Total invasive (<15mm) 45 & over England 1, ,966 2,527 4, North East North West , Yorkshire & Humber , East Midlands , West Midlands , East , London , South East , South West , England 1, ,572 1,898 3, North East North West , Yorkshire & Humber East Midlands West Midlands East London South East , South West Source : KC62 (Parts 1 and 3, Table T) Table 9a Breast screening programme : women screened and cancers detected by age, England Cancers detected Number Rate per 1,000 women screened Number of Total Non - invasive Non - invasive women number of or or screened women with micro - Small micro - Small Age (thousands) cancer invasive (<15mm) Total invasive (<15mm) Total 1, ,966 2,527 4, , ,572 1,898 3, , , , , , , , Over Source : KC62 (Parts 1 and 3, Table T)

18 Table 9b Breast screening programme : women aged screened and cancers detected by Strategic Health Authority, Cancers detected Number Rate per 1,000 women screened Number of Total Non - invasive Non - invasive women number of or or screened women with micro - Small micro - Small Strategic Health Authority (thousands) cancer invasive (<15mm) Total invasive (<15mm) England 1, ,572 1,898 3, County Durham & Tees Valley Northumberland, Tyne & Wear Cheshire & Merseyside Cumbria & Lancashire Greater Manchester North & East Yorkshire and Northern Lincolnshire South Yorkshire West Yorkshire Leicestershire, Northamptonshire & Rutland Trent Birmingham & The Black Country Shropshire & Staffordshire West Midlands South Bedfordshire & Hertfordshire Essex Norfolk, Suffolk & Cambridgeshire North Central London North East London North West London South East London South West London Hampshire & Isle Of Wight Kent & Medway Surrey & Sussex Thames Valley Avon, Gloucestershire & Wiltshire Somerset & Dorset South West Peninsula Source : KC62 (Parts 1 and 3, Table T)

19 Table 10 Breast screening programme : women aged 45 and over, with cancer diagnosed, by size of cancer and age, England numbers Age All ages Size of cancer 45 & over Over 70 All cancers 11,966 8, ,623 2,941 3,008 2, Invasive status not known Non-invasive or 2,364 1, possibly micro-invasive Definitely micro-invasive Invasive total 9,382 6, ,945 2,291 2,398 2, Small (less than 15mm) total 4,994 3, ,237 1,301 1, per 1,000 women screened as a percentage of total invasive Less than 10mm 2,338 1, Greater than or equal to 10mm and less than 15mm 2,656 1, Greater than or equal to 15mm and less than 20mm 1,862 1, Greater than or equal to 20mm and less than 50mm 2,172 1, Greater than or equal to 50mm Size not known Source : KC62 (Parts 1 and 3, Table T)

20 Table 10a Breast screening programme : women aged 50-64, with cancer diagnosed, by invitation type and size of cancer, England numbers Invitation type Routine Routine invitation to Total ages Routine invitation to previous attenders st invitation invitation previous attenders Last screen all invitation for routine to previous Last screen more than Size of cancer types screening non-attenders within 5 years 5 years previously Early recalls All cancers 8,572 1, , Invasive status not known Non-invasive or 1, , possibly micro-invasive Definitely micro-invasive Invasive total 6,634 1, , Small (less than 15mm) total 3, , per 1,000 women screened as a percentage of total invasive Less than 10mm 1, , Greater than or equal to 10mm and less than 15mm 1, , Greater than or equal to 15mm and less than 20mm 1, Greater than or equal to 20mm and less than 50mm 1, , Greater than or equal to 50mm Size not known Source : KC62 (Parts 1 and 3, Tables A to F2)

21 Table 11 Breast screening programme : coverage of women aged by Primary Care Organisation at 31 March, 2002, 2003, 2004 and 2005 As at 31 March As at 31 March 2004 As at 31 March 2005 Coverage Coverage Number of Coverage Number of Coverage Primary Care Organisation (less than 3 years (less than 3 years Eligible (1) women (less than 3 years Eligible (1) women (less than 3 years since last test) since last test) Population screened since last test) Population screened since last test) Code Name (%) (%) (000's) (000's) (%) (000's) (000's) (%) England ,538,224 2,651, ,574,534 2,697, North East , , , , County Durham & Tees Valley ,601 58, ,638 62, J9 Darlington ,099 5, ,218 4, KA Derwentside ,319 5, ,498 5, KC Durham and Chester-Le-Street ,989 7, ,035 9, J8 Durham Dales ,102 4, ,187 5, KD Easington ,871 5, ,948 5, D9 Hartlepool ,224 4, ,294 3, KN Langbaurgh ,936 5, ,954 6, KM Middlesbrough ,427 5, ,517 7, E1 North Tees ,538 8, ,737 10, KE Sedgefield ,096 5, ,250 4, Northumberland, Tyne & Wear ,882 77, ,816 78, KF Gateshead ,384 11, ,412 11, D7 Newcastle ,265 10, ,896 11, D8 North Tyneside ,546 11, ,976 11, TAC Northumberland Care Trust ,745 21, ,330 20, KG South Tyneside ,468 8, ,535 8, KL Sunderland Teaching ,474 14, ,667 15, North West , , , , Cheshire & Merseyside , , , , F8 Bebington and West Wirral ,083 7, ,140 7, H2 Birkenhead and Wallasey ,000 11, ,210 12, H4 Central Cheshire ,974 16, ,197 16, HA Central Liverpool ,995 10, ,808 10, H3 Cheshire West ,298 10, ,396 10, H5 Eastern Cheshire ,975 12, ,137 13, H6 Ellesmere Port and Neston ,412 5, ,423 5, J1 Halton ,470 6, ,667 6, J4 Knowsley ,632 6, ,501 6, G9 North Liverpool ,771 4, ,945 5, HC South Liverpool ,546 4, ,628 5, M5 South Sefton ,693 7, ,950 8, F9 Southport and Formby ,767 7, ,848 7, J3 St Helens ,364 11, ,451 11, J2 Warrington ,935 10, ,048 11, Cumbria and Lancashire , , , , CC Blackburn With Darwen ,443 7, ,600 6, HP Blackpool ,024 8, ,846 7, G8 Burnley, Pendle and Rossendale ,643 13, ,892 13, D4 Carlisle and District ,777 7, ,976 7, F2 Chorley and South Ribble ,975 11, ,214 12, D5 Eden Valley ,149 5, ,265 5, HE Fylde ,677 4, ,679 4, G7 Hyndburn and Ribble Valley ,047 6, ,133 6, DD Morecambe Bay ,438 19, ,766 19, HD Preston ,926 6, ,939 6, D6 West Cumbria ,398 8, ,468 8, F3 West Lancashire ,801 6, ,880 6, HF Wyre ,272 8, ,321 8, Greater Manchester , , , , HG Ashton, Leigh and Wigan ,428 18, ,464 16, HQ Bolton ,172 14, ,291 14, JX Bury ,346 10, ,511 10, CL Central Manchester ,797 4, ,839 4, F4 Heywood and Middleton ,698 3, ,806 3, CR North Manchester ,186 6, ,186 6, J5 Oldham ,544 9, ,686 10, JY Rochdale ,177 7, ,258 7, F5 Salford ,494 10, ,433 9, AA South Manchester ,429 5, ,594 4, F7 Stockport ,949 14, ,015 15, LH Tameside and Glossop ,191 12, ,358 11, F6 Trafford North ,868 2, ,897 4, CX Trafford South ,151 7, ,195 7, continued

22 Table 11 Breast screening programme : coverage of women aged by Primary Care Organisation at 31 March, 2002, 2003, 2004 and 2005 As at 31 March As at 31 March 2004 As at 31 March 2005 Coverage Coverage Number of Coverage Number of Coverage Primary Care Organisation (less than 3 years (less than 3 years Eligible (1) women (less than 3 years Eligible (1) women (less than 3 years since last test) since last test) Population screened since last test) Population screened since last test) Code Name (%) (%) (000's) (000's) (%) (000's) (000's) (%) England ,538,224 2,651, ,574,534 2,697, Yorkshire and Humber , , , , North & East Yorkshire & North Lincolnshire ,921 98, , , KJ Craven, Harrogate and Rural District ,475 13, ,676 13, E3 East Yorkshire ,928 9, ,079 9, E5 Eastern Hull ,551 5, ,661 5, KH Hambleton and Richmondshire ,552 8, ,661 8, AN North East Lincolnshire ,847 9, ,880 8, EF North Lincolnshire ,407 9, ,587 8, KK Scarborough, Whitby and Ryedale ,801 11, ,060 11, E2 Selby and York ,009 16, ,239 17, E6 West Hull ,646 7, ,672 7, E4 Yorkshire Wolds and Coast ,705 7, ,999 11, South Yorkshire ,807 70, ,245 73, JE Barnsley ,941 13, ,168 13, CK Doncaster Central ,056 3, ,118 5, EK Doncaster East ,813 5, ,820 5, EL Doncaster West ,252 5, ,303 5, EE North Sheffield ,993 6, ,052 6, H8 Rotherham ,014 14, ,076 14, EP Sheffield South West ,739 7, ,767 7, EN Sheffield West ,565 6, ,550 6, EQ South East Sheffield ,434 8, ,391 8, West Yorkshire , , , , AW Airedale ,372 6, ,513 6, CF Bradford City ,170 3, ,116 2, CG Bradford South and West ,576 7, ,710 6, J6 Calderdale ,248 11, ,368 10, HK East Leeds ,225 7, ,207 7, E7 Eastern Wakefield ,090 9, ,180 9, LJ Huddersfield Central ,690 6, ,805 6, HJ Leeds North East ,633 7, ,663 7, HM Leeds North West ,404 7, ,496 6, HH Leeds West ,899 4, ,926 3, CH North Bradford ,387 5, ,472 5, J7 North Kirklees ,255 8, ,390 8, LK South Huddersfield ,551 5, ,794 5, HL South Leeds ,525 6, ,559 6, E8 Wakefield West ,272 7, ,401 8, East Midlands , , , , Leicestershire, Northamptonshire & Rutland ,339 85, ,765 88, JC Charnwood & North West Leicestershire ,928 14, ,320 14, AC Daventry and South Northamptonshire ,848 6, ,105 6, EY Eastern Leicester ,954 6, ,144 6, JA Hinckley and Bosworth ,879 6, ,087 6, EJ Leicester City West ,661 5, ,740 5, EH Melton, Rutland and Harborough ,009 9, ,191 9, LW Northampton ,791 11, ,139 11, LV Northamptonshire Heartlands ,377 15, ,843 17, JD South Leicestershire ,892 9, ,196 9, Trent , , , , ED Amber Valley ,279 8, ,528 9, FA Ashfield ,965 4, ,039 4, ET Bassetlaw ,433 6, ,500 6, EV Broxtowe and Hucknall ,048 8, ,123 7, AL Central Derby ,634 5, ,560 6, EA Chesterfield ,951 7, ,030 6, H7 Derbyshire Dales and South Derbyshire ,895 5, ,043 5, H9 East Lincolnshire ,261 18, ,735 21, ER Erewash ,421 5, ,495 5, EC Gedling ,052 5, ,093 4, EX Greater Derby ,335 8, ,484 8, HN High Peak and Dales ,770 7, ,900 7, D3 Lincolnshire South West Teaching ,024 12, ,529 12, AM Mansfield District ,697 5, ,781 5, AP Newark and Sherwood ,728 7, ,839 8, EG North Eastern Derbyshire ,853 9, ,031 9, EM Nottingham City ,988 10, ,063 11, FC Rushcliffe ,898 7, ,045 6, D2 West Lincolnshire ,548 12, ,752 12, continued