Breast screening based on women’s risk level would reduce overdiagnosis

A targeted 'risk-based' breast screening programme could do 'more good than harm', reduce overdiagnosis, and be run at an affordable cost to the NHS, a UCL-led study found. The economic evaluation and simulation modelling study concluded that a screening initiative, which did not include low risk women, would improve the quality of life gained following screening, reduce overdiagnosis* and save resources, while maintaining the benefits of screening. Published in the peer reviewed journal JAMA oncology , - Lead author Dr Nora Pashayan (UCL Department of Applied Health Research) said:  "Breast screening has both benefits and harms: It can reduce death from breast cancer in some women while others may have unnecessary diagnosis and treatment of breast cancer. "Offering screening according to women's risk level could improve the efficiency of the screening programme and reduce its harms." In the UK the NHS Breast Screening Programme (NHSBSP) invites women aged 50-69, for a digital mammogram every three years. However, numerous studies have shown that the risk of developing breast cancers varies significantly among women, with genetic, lifestyle and reproductive factors increasing an individual's susceptibility. The research simulated three hypothetical cohorts of women, aged 50 and free of cancer, followed up over 35 years. Each cohort consisted of 364,500 women - the 2009 population of women aged 50 in England and Wales.