Age, test THreshold and frequency of Mammography screening (ATHENA-M)

  • Research type

    Research Study

  • Full title

    ATHENA-M Observational study of Age, test THreshold and frequency on English NAtional Mammography screening outcomes

  • IRAS ID

    289103

  • Contact name

    Sian Taylor-Phillips

  • Contact email

    s.taylor-phillips@warwick.ac.uk

  • Sponsor organisation

    University of Warwick

  • Clinicaltrials.gov Identifier

    BSP RAC 089, NHS Breast Screening Programme Research Advisory Committee

  • Duration of Study in the UK

    2 years, 11 months, 31 days

  • Research summary

    Breast cancer screening involves taking mammograms (x-rays) of womens breasts to search for signs of cancer. Different countries give different versions of breast screening, because we are not sure which is best. We are investigating the effect of three variations to breast screening on outcomes for women screened.
    Firstly, the test threshold. When radiologists examine the women’s mammograms it is often not clear whether cancer is present. The test threshold means how sure the radiologists are that cancer is present to recall the women for further tests. In the UK we recall 4% of women for further tests because their mammograms show suspicious signs. Other countries recall as few as 2% (Denmark) or as many as 10% (USA). We will investigate how recalling different proportions of women affects their long term outcomes, such as development of cancer, stage of cancer when detected, morbidity, mortality and overdiagnosis of cancer which would never have caused harm.
    Secondly the interval between screening invitations. In the UK breast screening is every 3 years, which is the longest time between screens in the world. In the US it is every year or 2 years and in Europe every 2 years. We will use the natural variation in English screening interval to investigate the impact on women’s outcomes.
    Thirdly the age women are invited for breast screening. In the year 2000 English breast screening upper age limit was extended from 64 to 70. We investigate the change on womens outcomes.
    We are undertaking ‘retrospective observational research’, meaning we look back at the different versions of breast screening women were offered in the past, and see which versions gave most benefit and least harm. We have records from offering different versions of breast screening to over 13 million women in England over the last 25 years.

  • REC name

    London - Hampstead Research Ethics Committee

  • REC reference

    21/LO/0120

  • Date of REC Opinion

    9 Feb 2021

  • REC opinion

    Favourable Opinion