Doubts over breast cancer screening in elderly

Doubts have emerged over proposals to extend UK breast cancer screening to women aged over 70, after a study of a similar initiative in the Netherlands found it did not reduce the number of advanced cancers.

Mammogram: screening elderly women may not cut advanced cancer rates (photo: Zephr/SPL)
Mammogram: screening elderly women may not cut advanced cancer rates (photo: Zephr/SPL)

Researchers found no reduction in numbers of advanced cancers detected after the Netherlands raised the upper age limit of breast screening from 69 to 75 years in 1998.

They looked at data from the country's cancer registry for 25,414 women aged 70-75 diagnosed with cancer between 1995 and 2011.

During this time detection rates for early stage breast cancer per 100,000 women increased from 260 to 382 in this agegroup.

However, there was no statistically significant change in advanced breast cancers detected, with rates at 59 per 100,000 in 1995, and 53 per 100,000 in 2011.

Researchers said a fall in advanced cancers would be expected from an effective screening programme, as it would detect cancers at an earlier stage and prevent them from progressing further.

Dr Gerrit-Jan Liefers from Leiden University Medical Centre in the Netherlands said: 'This implies that the effect of screening in elderly women is limited and leads to a large proportion of over-diagnosis.'

He said a risk prediction tool should be developed to identify which older women face a greater risk and should be offered screening, instead of screening the whole agegroup.

The NHS Breast Screening Programme does not routinely invite women over 70 for screening. However a trial is underway to extend screening to women aged 47-73, to assess whether it can reduce deaths from breast cancer. More than a million women have taken part so far.

Sally Greenbrook, senior policy officer at Breakthrough Breast Cancer, said: 'We know that screening is a controversial issue and many women find it difficult to decide whether or not to attend their screening appointment. That's why it's vital for women to have access to balanced information about the risks and benefits of breast screening so they are able to make an informed choice.'

The study was presented at the European Breast Cancer conference last week.

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