The UK National Health Service Breast Screening Programme (NHSBSP), a UK-wide programme of free mammographic screening for breast cancer, was introduced in 1988 following a recommendation from a working party established by the four UK Departments of Health and chaired by Sir Patrick Forrest. The working party concluded that there was evidence that screening for breast cancer could reduce mortality from the disease by up to 30%.
In Scotland, women aged 50-64 years were invited for a routine screen once every three years until 2003-04, when the age range for invitation was extended to include women up to the age of 70 years. This expansion was phased in throughout the country over a three year round of screening. Women over 70 years are still screened three yearly on request.
Data is collected by the 6 screening centres in Scotland using the breast screening system. The necessary files are then requested by Data Management (PHI/ISD) in order to produce the data required for the publication.
Breast screening is split into two parts in a biannual process.
The first part of this process is the KC62 aspect, and deals with the worst case referrals to the breast screening programme.
Data is collected from all 6 screening centres as well as NHS Board level for all eligible women within Scotland.
The process begins in mid January each year with data requested from Atos (supplier of the breast screening system). Data is then structured so that the correct headings and layout are applied to each of the files.
Throughout this process standards for the 50 to 70 age group are produced by detailing uptake, numbers screened and diagnosis of cancer. A 1 year and 3 year report is also produced for NHS Boards data.
The second part of the breast screening process is the British Association of Surgical Oncologists (BASO) audit.
The main breast screening audit starts with a clean-up process for the 6 centres in early July. This process is used to highlight any data anomalies e.g. cases with more than one CHI, where there is nodal information but no axillary procedure is listed, and invasive cancer is present but there is no nodal information recorded, etc. A spreadsheet is sent out to each centre detailing the areas to investigate and the Boards are given 4 weeks to update their database with any further information.
West Midlands Cancer Intelligence Unit (WMCIU) will then send the current years template and timetable for the audit in August. The template is sent to Atos to populate with the required information, and this completed information is then used in ISD's publication and also by WMCIU.
High level checks are carried out on the files received for the KC62 to ensure that the expected number of records have been received from the screening centre and NHS board level data.
Working with data analysts (data users), outputs are checked for accuracy, any issues with the data highlighted and if required re-run and resent by Atos.
In the main audit (BASO) missing data is highlighted for each screening centre and this is followed up with the centres. Again working with data analysts data is checked for completeness, and any outstanding query followed up with centres with any changes or explanations incorporated.
Data Monitoring and Support
The Data Monitoring and Support team works with:
- Atos to address any issues with the submission of the required data fields to ISD.
- The Centres in Aberdeen, Dundee, Edinburgh, Glasgow, Irvine and Inverness to address data completeness issues, any queries regarding definition of an item, the explanations required in the main audit for missing data support to meet the deadline for the audit and provide updated guidance received from WMCIU.
- WMCIU to ensure that the caseload information for each centre is as complete as possible, and that the unique ISD number for each clinician within the audit matched the GMC details.
Links to further information