Cancer screening

Looking at breast, cervical and bowel screening data, this indicator examines whether coverage has changed over time.

Indicator

Last updated: 18/07/2019

Effective clinical care
Primary and community care International

Background

Screening can detect early signs of cancer in people who are not experiencing symptoms. Early detection is important because treatment is more likely to be successful and the chances of survival are much better. In the UK, there are national screening programmes for breast, cervical and bowel cancer. These services save almost 9,000 lives each year. In November 2018, NHS England commissioned an independent review of the National Cancer Screening programmes in England. An interim report of emerging findings was published in May 2019. The results of the review will be taken forward as part of the implementation of the NHS Long Term Plan.


How has breast screening coverage in England changed over time? 18/07/2019

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Women between the ages of 50 and 70 are invited for regular breast screening (every three years) under the NHS Breast Screening Programme. Coverage is the percentage of women in the population who are eligible for screening who have been screened within the last three years. The national lower threshold is 70% and the agreed standard for coverage is 80%.

Breast screening coverage in England increased from 64% in 2002 to 77% in 2009, where it remained stable until 2012 when it gradually began to decrease. In 2018, breast screening coverage was 75%; six million women were eligible for screening and 4.5 million women had been screened within the last three years. Coverage was highest in the 65-69 age group (76%) and lowest in the 53-54 age group (73%). There was also regional variation, with the East Midlands reporting the highest coverage at 78% and London reporting the lowest coverage at 69%.


How has cervical screening coverage in England changed over time? 18/07/2019

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Women between the ages of 25 and 64 are invited for regular cervical screening under the NHS Cervical Screening Programme. Coverage is the percentage of women in the population who are eligible for screening who were screened adequately within the last three and a half years (for women aged 25-49) and five and a half years (for women aged 50-64). The national lower threshold is set at 75% and the standard for coverage is 80%.

Cervical screening coverage for the total target age group (25 to 64 years) fell from 76% in 2011 to 71% in 2018. 15 million women were eligible for cervical screening in 2018 and 10.7 million women were screened within the specified target period. Coverage among women aged 25 to 49 years decreased from 74% in 2011 to 69% in 2018. For women aged 50 to 64 years, coverage fell from 80% in 2011 to 76% in 2018. Coverage is consistently higher in the older age group (50-64 years) than the younger age group (25-49 years). At a regional level, coverage for the total target age group ranged from 65% in London to 75% in the East Midlands.

The incidence of cervical cancer is expected to decrease as the effects of the human papilloma virus (HPV) vaccination emerge. In March 2019, Public Health England launched a national cervical screening campaign with the aim of helping women understand and be less fearful of cervical screening and to improve uptake. It was announced in 2016 that HPV primary screening will be implemented into the NHS Cervical Screening Programme, with full geographical coverage achieved across England by 2020.


How has bowel screening coverage in England changed over time? 18/07/2019

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Bowel cancer screening in the form of a home-testing kit is offered to men and women aged 60 to 74 every two years. From June 2019, the faecal immunochemical test (FIT) replaced the faecal occult blood (FOB) test. An additional one-off bowel scope screening test is being introduced in England at the age of 55. In August 2018, it was announced that bowel cancer screening in England will in the future start at the age of 50. NHS England and Public Health England are now considering how to lower the screening age as part of the NHS Long Term Plan.

This indicator measures the coverage of men and women who were eligible for FOB test screening who were screened adequately within the last two and a half years. The national lower threshold is 55% and the standard for coverage is 60%.

Bowel screening coverage in England increased from 35% in 2009/10 to 59.6% in 2017/18. Performance against the bowel screening standards is improving, but from a lower starting point than the other screening programmes. The lower threshold target was met in 2017/18, and the standard target was almost met.


How does the UK's breast cancer screening coverage compare internationally? 15/07/2018

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The OECD collects international data on breast cancer screening (mammography) for women aged 50-69. Some countries supply survey data (denoted by ^ in the chart) and others supply programme data (denoted by *).

In the UK, breast screening coverage has remained relatively steady over time with an average of 76%. While the UK outperforms many OECD countries including France and Germany, breast screening coverage is higher in the Netherlands and Finland.


How does the UK's cervical cancer screening coverage compare internationally? 15/07/2018

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The OECD also collects international data on cervical cancer screening for women aged 20-69. Again, some countries supply survey data (denoted by ^ in the chart) and others supply programme data (denoted by *).

Compared to other countries, the UK has one of the highest cervical cancer screening rates. However, there has been a gradual decrease in the proportion of women screened over time from 84% in 2000 to 77% in 2016.


About this data

Data on screening coverage in England was collected by the NHS Cancer Screening Programmes. Coverage is defined as the percentage of people in the population who are eligible for screening at a particular point in time, who have had a test with a recorded result at least once within the screening round.

Breast screening coverage is assessed using the 53 to 70 age group, as women may first be called at any time between their 50th and 53rd birthdays. Caution should be used in interpreting the bowel screening data as not all CCGs had full implementation of the programme in the recorded period.

OECD breast cancer screening data is based on the number of women aged 50-69 who have received a bilateral mammography within the past two years (or according to the specific screening frequency recommended in each country) divided by the number of women aged 50-69 answering survey questions on mammography (for survey-based data) or eligible for an organised screening programme (for programme-based data).

OECD cervical cancer screening data is based on the number of women aged 20-69 who have been screened for cervical cancer within the past three years (or according to the specific screening frequency recommended in each country) divided by the number of women aged 20-69 answering the survey question (for survey-based data) or eligible for an organised screening programme (for programme-based data).

For information about limitations in comparability of OECD data, please see Health at a Glance 2017.

Key:

^ = Survey data

* = Programme data

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