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Implementing Risk-Stratified Breast Screening in England: An Agenda Setting Meeting.

Lorna McWilliams^1,2, D Gareth Evans^2,3,4,5, Katherine Payne^2,6

¹Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK.

|October 14, 2022

Summary

This summary is machine-generated.

Implementing risk-stratified breast screening in the NHS Breast Screening Programme (NHSBSP) is feasible and desirable. Experts identified key issues for integrating this personalized approach into current services.

Keywords:

breast cancer cost-effectiveness epidemiology health inequalities mammography risk stratification screening

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Area of Science:

Oncology
Public Health
Health Services Research

Background:

The National Health Service Breast Screening Programme (NHSBSP) currently screens most women every three years, irrespective of individual breast cancer risk.
Advances allow for accurate breast cancer risk assessment, risk-based feedback, and tailored management strategies, including enhanced screening and preventative medication for high-risk individuals.

Framework:

A 2022 meeting convened 58 experts to discuss the feasibility and desirability of implementing risk-stratified screening within the NHSBSP.
Discussions were informed by findings from the PROCAS2 NIHR programme grant on the practicalities of risk-stratified screening.
Thematic analysis of expert discussions identified five key themes: risk/economic modeling, health inequalities/communication, screening interval adjustments, integration with existing services, and new service models.

Implementation:

Participants generally anticipated the future implementation of risk-stratified breast screening in England.
Key challenges and uncertainties were identified across the five discussed themes, requiring resolution for successful integration.
The meeting aimed to set an agenda for addressing these challenges and facilitating the adoption of risk-stratified screening.

Implications:

Successful implementation could lead to more personalized and potentially more effective breast cancer screening strategies.
Addressing health inequalities and communication is crucial for equitable delivery of risk-stratified services.
Further research and policy development are needed to resolve identified issues and optimize new service models for risk-stratified breast screening.