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Breast cancer screening error: fatal mistake or lucky escape?

BMJ 2018; 361 doi: (Published 08 May 2018) Cite this as: BMJ 2018;361:k2036
  1. Nigel Hawkes
  1. London

Last week it emerged that a cohort of older women had missed out on mammography invitations. Nigel Hawkes looks behind the headlines

How was the error found?

Public Health England says that it spotted anomalies when it analysed data from the AgeX trial, a cluster randomised trial run from Oxford University to investigate the benefits and risks of extending screening to younger and older ages. “The numbers randomised to screening in the older group were too low,” a PHE spokesperson said.

Every year 350 000 women ought to have had invitations to screening, but over the previous nine years, the average had fallen short by 50 000 a year, making up the 450 000 missed invitations quoted by Jeremy Hunt in parliament on 2 May.

What caused it?

Nobody’s saying. Hunt blamed IT system failures, including “how age parameters are programmed into the system.” One suggestion is that the cut-off had been set at 70, not 71, thereby excluding women who had not yet reached their 71st birthday and should have been included. PHE couldn’t confirm this when asked by The BMJ, instead blaming “several different IT issues.”

How many extra deaths have occurred as a result?

Hunt said that PHE modelling indicated that between 135 and 270 women had had their lives shortened. A calculation by …

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