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Updated: Jul 14, 2026

An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
Cumulative attendance, assessment and cancer detection rate over four screening rounds in five English
Matthew Wallis1, Fergus Neilson, Helen Hogarth
1Breast Screening Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, United Kingdom. mgwallis12@aol.com
Background:
Data collection in the National Health Service Breast Screening Programme monitors performance in a different cohort of women each year.
Methods:
This paper follows a single cohort study of 57,425 women (aged 50-53, when first invited) over four screening rounds to find: how many women attend screening and how often; how many were assessed; how many times they were assessed; and the number of cancers detected at each round.
Results:
Average attendance in each round was 76.9% and has remained constant. Only 62% of women have attended all four rounds, but 89.9% have been screened at least once, the average number of attendances being 3.5. Average assessment rate decreased from 7.3 to 3.5%. A total of 11.3% of women were assessed once, 0.91% twice and 0.06% three times. Cancer detection rates have more than doubled from 3.3 per 1000 screened to 6.9.
Conclusions:
Current monitoring shows constant uptake over time, but when looking at a cohort of individual woman, a much larger percentage have 'ever' attended and a smaller number have attended all invitations. The chance of a woman being assessed at all, if she attends all four rounds, is 12.3%, which can be calculated by summating the recall rates in each round.
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