Cancer: breast screening (53 to 70 years)

  • NICE indicator
  • IND65
  • Published:
  • Last updated:
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Indicator

The proportion of women aged 53 to 70 years whose record shows a breast screening test has been performed within the last 3 years.

Indicator type

Network / system level indicator. The indicator would be appropriate to understand and report on the performance of networks or systems of providers.

This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.

To find out how to use indicators and how we develop them, see our NICE indicator process guide.

Rationale

The aim of breast screening is to reduce mortality by finding breast cancer at an early stage often when any changes in the breast are too small to notice. Cancer Research UK report (England, women diagnosed between 2016 and 2020) data that shows if breast cancer is diagnosed at stage 1, almost 100% of women will survive for 5 years or more, compared to more than 70% of women if diagnosed at stage 3 and more than 25% of women diagnosed at stage 4 (Cancer Research UK [2023] Survival for breast cancer). Cancer Research UK (2022) also report that 9,509 women died from breast cancer in 2017 to 2019 in England (11,415 in the UK). Age-specific mortality rates rise steadily from around age 30 to 34 (3.4 per 100,000) and more steeply from around age 65 to 69 (58.0 and over per 100,000 of the female population. The screening programme is therefore focused on women approaching this age and those already aged 60 to 70 (Breast cancer mortality statistics).

Data from the Office for Health Improvement and Disparities (OHID, indicator ID 94063) shows that coverage in 2022 to 2023 was 66.6%, based on screening coverage by GP practice. OHID indicator ID 94063: data for all area types, PCNs (v.27/10/23) shows geographical variation among primary care networks, with coverage ranging from 9.5% to 84.5%.

Specification

Numerator: Of the denominator, the number of women registered to the practice who were screened adequately in the previous 36 months.

Denominator: The number of eligible women (aged 53 to 70 years old) on the last day of the review period.

Caveat: Women registered with a GP but with no recorded address on Spine will be counted in the denominator but it will not be possible to invite them.

Calculation: Numerator divided by the denominator, multiplied by 100.

Exclusion: Women who have had a bilateral mastectomy (adapted from NHS England's Breast cancer screening programme standards valid for data collected from 1 April 2021 [BSP-SO2: coverage]).

Personalised care adjustments or exception reporting should be considered to account for situations where the patient declines or does not attend.

Data source: As described in the definitions section of OHID's published indicator ID 94063: Fingertips Cancer Services profile indicator: Breast screening coverage: aged 53 to 70 years old.

Expected population size: Underlying data for OHID indicator ID 94063 (data for England, age 53 to 70, denominator) for 2022 to 2023 and the Office of National Statistics (2024) population estimates for the UK, England, Wales, Scotland, and Northern Ireland: England, mid-2022 show that 0.11% (6,485,765 divided by 57,106,000) of people in England are eligible for breast screening: 1,136 per 10,000 patients served by a network. There is no minimum number of patients required for network level indicators. However, consideration should be given to whether the majority of results would require suppression because of small numbers.