Changes will be made in the way women are invited for breast screening in Scotland after “two major adverse events” where patients were missed.
Women are normally invited via their GP practice, which groups patients based on their eligibility for mammograms, which are offered to those aged between 50 and 70 every three years.
However, a Scottish Government-led review of the screening programme noted that women eligible for screening had been put at risk “in recent years” because IT systems failed to track patients who had moved to a different GP practice.
A new approach is recommended where women will be called by a screening centre based on the date of their last mammogram.
Newly eligible women of 50 would be brought into the system and allocated a recall date based on their date of birth.
In January, letters were sent “as a matter of urgency” to 242 patients in the NHS Lothian area and efforts were made to trace 127 who had left the area afterstaff realised that patients had not been called for their mammograms.
They included women with mutations in the BRCA1 and BRCA2 genes, which significantly increase the chance of developing breast cancer, and patients who have already suffered the disease.
The review has made 17 recommendations to improve screening processes amid concern over a steady decline in uptake rates.
Average uptake over the last 10-years is 72%, just above the minimum acceptable standard of 70%. Both NHS Greater Glasgow and Clyde and NHS Lanarkshire are failing to meet this.
Under six in ten women (59.5%) from the most deprived communities attend compared with almost eight in ten women (79.7%) living in the most affluent areas.
Some women who were interviewed for the report said they believed mammograms were unnecessary “if self examination revealed no lumps.”
However, the report noted that around half of breast tumours detected by screening would not have been picked up with a physical examination.
More than 1700 cancers were detected using mammograms in Scotland over 2018-2019 and in 49% of cases the tumour was less than 15mm.
The Scottish Government said the data re-enforced the importance of screening for the early detection of breast cancer.
The review also recommends that evening and weekend appointments should be available.
Some women said they were reluctant to ask for time off work to attend screening appointments as they felt these were not viewed as a priority by their employers.
It also calls for improvements in mobile screening provision in rural areas and also a static satellite screening centre to boost uptake in the the central belt, particularly in deprived areas.
Siting of mobile screening units within local supermarket car parks was said to cause “emotional discomfort” for some women.
The review recommends placing units next to GPs or well woman services.
A new screening task force, chaired by Dr Marzi Davies, will take forward the recommendations from the report as well as considering additional ways to modernise the service.
Those aged 71 years and over will be able to opt to self-refer for appointments once again from autumn 2022.
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