Radiation risk with digital mammography in breast screening

This review estimates the risks and benefits of breast screening in terms of deaths due to radiation-induced cancers and lives saved by digital mammography in the NHS Breast Screening Programme in England.

A radiation risk model, patient dose data and data from national screening statistics were used to estimate the number of deaths due to radiation induced breast cancers in the NHSBSP in England. The breast cancer mortality reduction in the invited population due to screening, and the percentage of women diagnosed with symptomatic breast cancer who die from that cancer, were collated from the literature. The number of lives saved due to screening was calculated.

The main findings are that:

• the risk of a radiation-induced cancer for a woman attending full field digital mammographic screening (2 views) by the NHSBSP is between 1 in 49,000 to 1 in 98,000 per visit
• if a woman attends all 7 screening examinations between the ages of 50 to 70, the risk of a radiation-induced cancer is between 1 in 7,000 to 1 in 14,000
• it is estimated that about 400 to 800 cancers are detected by the NHSBSP for every cancer induced
• the mortality benefit of screening exceeds the radiation-induced detriment by about 150:1 to 300:1
• for the small proportion of women with breasts thicker than 90mm who receive higher radiation doses, the benefit will exceed the risk by about 100:1 to 200:1

Full report at Public Health England

New two-year progress report on delivering the cancer strategy 2015-2020

NHS England’s National Cancer Programme Progress Report (2016-17) shows that the NHS is on track to transform cancer services by 2020/21 | NHS England

NHS England’s two-year progress report shows significant progress has been made towards delivering world-class cancer services in England. Improvements include a £130m investment (over 2016/18) in new and upgraded radiotherapy equipment and £200m over two years to accelerate rapid diagnosis and enhance patients’ quality of life.

The report describes progress across the field including:

• Modernisation of radiotherapy equipment throughout the country.
• New models of care introduced to ensure cancer is diagnosed earlier and improve survival.
• Establishment of Cancer Alliances across the country to bring together clinical leaders, healthcare workers, patients and charities for better coordination of care.

Full document: Achieving World-Class Cancer Outcomes: A Strategy for England 2015-2020

Cancer screening: informed consent

Public Health England has updated the Cancer Screening: Informed consent guidelines.

These guidelines give commissioners, providers and healthcare professionals in cancer screening information on consent to screening and procedures.

The document covers information and advice on:

• breast screening
• cervical screening
• bowel cancer screening
• mental capacity and consent

It also provides several template letters for patients withdrawing from programmes.

Changes to cancer waiting times system and dataset

NHS England is planning changes to the cancer waiting times (CWT) system and dataset, which will come into effect from April 2018.

The changes are part of a programme of work to implement the new 28 day faster diagnosis standard by 2020. The CWT system enables CCGs to monitor and manage pathways of care for cancer patients. An information standards notice published on 28 September sets out the forthcoming changes, and an updated guidance document for CWT standards will be published later this year.

Further detail available via NHS Digitial