NEWS Women surveyed on breast screening
Most women (85%) would back the idea of more frequent breast screening if they are at higher genetic risk of developing breast cancer, according to research published by The Breast. Fewer women (60%) would be happy to be screened less often if they were found to be at lower risk. More than 940 women from across the UK
were asked for their views on the possibility of tailoring breast screening to people’s genetic risk in a study funded by Cancer Research UK and The Eve Appeal. Two-thirds (66%) supported the idea of adjusting the frequency of screening on the basis of risk. The NHS breast screening programme
offers routine mammograms based on age, rather than genetic risk. All women between 50 and 70 are invited for screening every three years, and women over 70 can request screening if they wish, because older women are at
increased risk of the disease. Women with a strong family history of breast cancer may be offered a different pattern of screening. Breast screening can help detect cancers early, when treatment is more likely to be effective, and is estimated to save around 1,300 lives from breast cancer in the UK each year. But as well as picking up cancers that need treating, screening can also detect very slow-growing cancers that would not have been picked up without screening. This means some women are treated unnecessarily for a cancer that would not have caused any problem during their lifetimes. Dr Susanne Meisel, research psychologist at University College London, said: “Looking at whether genetic risk could be used to tailor and improve the breast screening programme is still at an early stage, but it’s useful to find out now what the public might think about this idea.
Our study showed that, overall, women seem to support it.”
Athena Lamnisos, CEO of The Eve Appeal,
said: “Women at increased risk of cancer deserve more than the one-size fits all approach. This study shows that women were positive about the idea of adjusting the frequency of mammography screening in line with personal genetic risk. It also shows how critical it is to develop effective communication materials – both for women at high risk and those at lower genetic risk.”
Jessica Kirby, Cancer Research UK, said:
“Breast screening saves lives, but it also has risks. One suggestion to try to maximise the benefit and reduce the risk is to tailor screening more effectively to people’s risk of breast cancer, but more research is needed to show whether this approach will be effective or possible.”
Calls for fundamental changes to deliver ‘Forward View’
A new report from The King’s Fund has called for fundamental changes in how health services are commissioned, paid for and regulated to deliver the vision set out in the NHS Five Year Forward View. The Forward View has been endorsed by all three main political parties and will set the agenda for NHS reform in the next parliament. However, without significant changes to policy and new approaches to leadership in the NHS, The King’s Fund argues that it risks suffering the fate of previous policy documents which have failed to deliver on their ambitions. The report argues that dealing with growing
financial and service pressures could crowd out the time and space needed to implement long- term changes to NHS services. It argues that delivering these changes will require leadership of the highest order, with much resting on whether the coalition of NHS bodies assembled behind the Forward View can be kept in place. The report makes the following
recommendations: • An integrated approach to commissioning is needed, with a much greater emphasis on pooling budgets currently held by NHS England, clinical commissioning groups and local authorities.
• New ways of paying for NHS services should incentivise the delivery of integrated care instead of encouraging admissions to hospital as under the current system of Payment by Results.
• The Care Quality Commission’s work should focus on assessing how well care is integrated across local systems of care rather than just inspecting individual NHS organisations.
• A national strategy for quality improvement and leadership development is needed to ensure the NHS becomes a ‘learning organisation’ focused on improving quality of care.
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APRIL 2015
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