The decision follows analysis by Public Health England (PHE) dating back to 2009, which found that a number of invitations for a final test had not been sent out to women, between their 68th and 71st birthday. The total number of older women affected since 2009 is estimated to be approximately 450,000.
The routine NHS breast screening programme invites more than 2.5 million women every year for a test, with women between the ages of 50 to 70 receiving a screen every 3 years up to their 71st birthday. Around 2 million women take up the offer.
The problem was identified in January 2018 whilst reviewing the progress of the age extension trial (AgeX). It then became apparent that a similar impact has resulted from long term problems with the routine programme as well. In addition, some local services have not invited everyone for a final screen in the 3 years before their 71st birthday.
PHE has carried out a thorough investigation including a detailed analysis of data going back to 2009 and has been advised by experts and clinicians. The fault has now been identified and fixed and women who did not receive their final routine invitation and are registered with a GP are being contacted and offered the opportunity to have a catch up screen. All of these women will be contacted by the end of May 2018. Women can seek advice by calling the helpline on 0800 169 2692. We anticipate that all rescreens will be completed by the end of October 2018 and extra capacity is being identified so that routine screening will not be affected.
Dr Jenny Harries, PHE Deputy Medical Director said:
On behalf of NHS breast screening services, we apologise to the women affected and we are writing to them to offer a catch-up screening appointment. They and their families’ wellbeing is our top priority and we are very sorry for these faults in the system.
A complex IT problem with the breast screening invitation system has led to some women not being invited for their final screen between their 68th and 71st birthdays. We have carried out urgent work to identify the problem and have fixed it. Additional failsafe systems have been introduced to ensure the problem does not reoccur.
The NHS breast screening programme is a world leading prevention service for women in England detecting around 18,400 cancers per year and saving 1,300 lives.
Local breast screening services are currently working closely with NHS England and PHE to ensure that all of the women affected are contacted and offered the opportunity for a screen.
The Secretary of State for Health and Social Care has commissioned an independent review of the NHS breast screening programme to look at issues, including its processes, IT systems and further changes and improvements that can be made to the system to minimise the risk of any repetition of this incident.
The review will be chaired by Lynda Thomas, Chief Executive of Macmillan Cancer Support and Professor Martin Gore, Consultant Medical Oncologist and Professor of Cancer Medicine at The Royal Marsden, and is expected to report in 6 months.
It is estimated that 450,000 women since 2009 were not invited for a screen and 309,000 women were not invited for a screen and are alive.
The long term clinical research trial called AgeX, led by Oxford University, is ongoing to assess reliably the risks and benefits of offering an extra screen to women aged 71 to 73 and between 47 to 49 years.
All women that were not sent an invitation for their final screen will be given the opportunity for a new screening appointment. All women under 72 years old who are affected will receive an appointment letter informing them of their time and date. Women aged 72 years old and above will be able to contact a dedicated helpline to discuss whether a screen could benefit them.
There are 79 local NHS breast screening services across the country. Women are routinely screened every three years, with the number of women invited per screening service ranging from 25,738 to 254,645.
An independent panel concluded in 2012 that, while routine breast screening at ages 50 to 70 confers significant benefit to UK women, the advantages and disadvantages of starting breast screening at younger or older ages were uncertain. A clinical trial, AgeX led by Oxford University, is ongoing to assess reliably the risks and benefits of offering an extra screen to women aged 71 to 73 and between 47 to 49 years.
The total number of women screened in 2016 to 2017 was 2.2 million (2,199,342). The number of women invited was 2.9 million (2,959,979).
In developing its response to this issue, PHE consulted an expert clinical group including radiologists, consultant breast surgeons, oncologists and epidemiologists.