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Women who reported only having had mammograms outside the screening program had the highest cumulative rate of breast cancer.
RR calculated for women who reported never having a mammogram (never) and those who only had mammograms outside the screening program (outside program).
Furthermore, the incidence rate decrease expected after the end of screening might be less relevant than expected because women will continue to receive mammograms outside the screening programme.
And, from our data, it is easy to conclude that the majority of women that receive regular mammograms outside the BCSP receive annual mammograms.
Notably, the only significant difference in cumulative rates of cancer was between women who had mammograms outside the program and those who never had mammograms, i.e., between the two groups in the 'control' group (p = 0∙05).
Of those indicating participation in the NBCSP, 83% responded the same 7 years later and for those indicating that they only had mammograms outside the NBCSP, 78% responded the same 7 years later.
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Therefore, around 14% of women in the BCSP target group received mammograms outside of the program.
Differences between women in the control group, i.e., those who had a mammogram outside the program and those who never had a mammogram, were statistically significant for all risk factors (p < 0∙05).
The control group consisted of two subpopulations, those who only had a mammogram outside the program (RRadj =1∙04; 0∙86 to 1∙26) and those who never had a mammogram (RRadj = 0∙77; 0∙59 to 1∙01).
Of all women in the target population, 94.6% (3092 out of 3269) therefore underwent mammography after a previous false-positive referral, either being a scheduled screening examination or a clinical surveillance mammogram outside the screening programme.
In fact, the MSP not only missed a small number of interval cancers (n = 34) but also did not cover the cancers occurring in patients excluded for screening because of a recent mammogram outside the MSP (n = 56) and in women who refused to participate in the screening program.
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Justyna Jupowicz-Kozak
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