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An on-island breast screening programme has existed since March 1995, with a 2-year screening round.
A woman who has just had a negative breast examination and mammogram, as the United Kingdom breast screening programme has shown, has about one third the absolute risk of breast cancer in the following three years [ 33].
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Annually since 1996, screen-detected breast cancers within the NHS Breast Screening Programme have been audited at a national level.
The pathological and biological features of a consecutive series of impalpable invasive breast carcinoma, detected by mammography in the prevalent round of the breast screening programme, have been compared with a clinically presenting group of carcinomas in age-matched patients.
Digitisation of the breast cancer screening programme has recently been completed and in our breast screening region, transformation from analogue to digital screening took place in May 2009.
The NHS breast cancer screening programme has just extended the age limit for actually inviting women to be screened to 70 years.
As there is unlikely to be any phenotypic drift from ER-positive to ER-negative status within breast cancers, it is possible that the screening programme has merely detected an excess of ER-positive breast cancers, which have developed as a result of a true change in biology.
Whether the screening programme has reduced the mortality from breast cancer is a controversial issue.
This integrated screening programme has provided oral inspection for oral/throat cancer, mammography for breast cancer, Pap smear for cervical cancer and FIT for colorectal cancer since 2005.
Details of the nation-wide breast cancer screening programme have been described previously (Fracheboud et al, 1998; Duijm et al, 2004).
In England, a national breast screening programme (NHSBSP) has been in place since 1988, and assessment of its impact on breast cancer incidence and mortality is essential to ensure that the programme is indeed doing more good than harm.
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