Table 5b. Comparison of the UK's screening strategy as implemented in the United Kingdom.
|
Genetic mutation |
BRCA1 |
BRCA2 |
||||
|---|---|---|---|---|---|---|
| Screening strategy | NL | UK | US | NL | UK | US |
| Small tumours detected (<2 cm) |
684±12 |
552±18 |
748±11 |
670±12 |
545±15 |
755±9 |
| Tumours detected |
731±21 |
624±18 |
781±25 |
715±16 |
618±21 |
781±16 |
| Interval cancers |
144±13 |
241±14 |
114±9 |
146±13 |
241±15 |
101±10 |
| Tumours diagnosed before start of screening |
37±8 |
76±8 |
41±7 |
16±4 |
37±6 |
17±4 |
| Tumours diagnosed after end of screening |
83±8 |
100±10 |
54±5 |
110±13 |
129±7 |
64±9 |
| Mammography examinations in hospital ( × 1000) |
19.0±0.4 |
15.2±0.1 |
24.7±0.3 |
21.1±0.3 |
16.6±02 |
27.4±0.4 |
| Mammography examinations in NBSP ( × 1000) |
0.7±0.1 |
2.2±0.1 |
N.A. |
0.9±0.1 |
2.7±0.1 |
N.A. |
| MRI examinations ( × 1000) |
23.4±0.4 |
15.1±0.1 |
24.2±0.3 |
25.7±0.3 |
16.5±0.2 |
26.8±0.4 |
| False-positive mammographies |
909±21 |
778±25 |
1.097±21 |
1.015±33 |
871±27 |
1.222±33 |
| False-positive MRIs |
3.134±79 |
2.035±28 |
3.273±62 |
3.457±59 |
2.245±49 |
3.624±77 |
| Years of life gained (years per woman)a |
1.625 |
1.368 |
1.628 |
1.231 |
1.077 |
1.231 |
| Additional costs ( × 1000 per woman)b |
2.153 |
1.454 |
2.350 |
2.339 |
1.588 |
2.550 |
| Additional costs per life-year gained compared with the UK strategy ( × 1000 per year per woman) | 2.7 | — | 3.4 | 4.9 | — | 6.2 |
Abbreviations: MRI=magnetic resonance imaging; N.A.=not applicable; NBSP=National Breast Cancer Screening Program; NL=The Netherlands.
Comparison of the UK's screening strategy as implemented in the United Kingdom with the Dutch (NL) and American (US) screening strategy when implemented in the United Kingdom, assuming simultaneous application of the UK NBSP. Average values of absolute numbers±s.d. per 1000 women with a BRCA1 or BRCA2 genetic mutation.
a
Reference is British NBSP.
b
Additional costs with reference to British NBSP, all cost estimates based on British prices.