br F Degliangeli P Kshirsagar V Brunetti P P Pompa
 F. Degliangeli, P. Kshirsagar, V. Brunetti, P.P. Pompa, R. Fiammengo, Absolute
and direct microRNA quantification using DNA-gold nanoparticle probes,
 Y.W. Tang, D. Persing, Diagnostic Microbiology, Academic Press, Cambridge,
A. Tagliamonte, P. Neri, Synthetic peptides in the form of dendrimers become
Development and application of a sybr green RT-PCR for first line screening
 https://www.promega.com.cn/products/mass spectrometry/proteases-and-
and quantification of porcine sapovirus infection, BMC Vet. Res. 8 (2012)
surfactants/sequencing -grade-modified-trypsin/?catNum¼V5111. (Accessed
in a single cell with droplet digital pcr based on ligation reaction, Anal. Chem.
rolling circle amplification strategy for highly sensitive microRNA detection,
throughput microRNA expression profiling from total RNA, Nucleic Acids Res.
detection by DNA-scaffolded silver-nanocluster probe based on isothermal
for Industry: Bioanalytical Method Validation, US Department of Health and
Human Services, Food and Drug Administration, .
molecular beacons for highly sensitive and selective detection of microRNAs
M. Kirby, B. Stouffer, W.G. Humphreys, Liquid chromatography and tandem
based on duplex specific nuclease signal amplification, Chem. Commun. 49
mass spectrometry method for the quantitative determination of saxagliptin
and its major pharmacologically active 5-monohydroxy metabolite in human
plasma: method validation and overcoming specific and non-specific binding,
J. Detmer, L. Shen, A branched DNA signal amplification assay for quantifi-
cation of nucleic LY294002 targets below 100 molecules/ml, Nucleic Acids Res. 25
MicroRNA miR-21 overexpression in human breast cancer is associated with
 J. Li, Z. Li, Dendrimer-supported catalysts for organic synthesis, Curr. Org.
advanced clinical stage, lymph node metastasis and patient poor prognosis,
 M.A. Swiderska, J.L. Reymond, Analytical chemistry: a dendritic signal
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An analysis of 11.3 million screening tests examining the association between needle biopsy rates and cancer detection rates in the English NHS Breast Cancer Screening Programme
a Cancer Epidemiology Unit, Nuffield Department of Population Health, Oxford University, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK b Department of Radiology, St Georges University Hospital Foundation Trust, UK
c Breast Screening Programme, Public Health England, London, UK
d Cambridge Breast Unit, NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Trust, UK
article in formation
AIM: To examine the association between recall, needle biopsy, and cancer detection rates to inform the setting of target ranges to optimise the benefit to harm ratio of breast screening programmes.
MATERIALS AND METHODS: Annual screening programme information from 2009/10 to 2015/16 for the 80 screening units of the English National Health Service Breast Screening Programme (totalling 11.3 million screening tests) was obtained from annual (KC62) returns. Linear regression models were used to examine the association between needle biopsy rates and recall rates and non-linear regression models to examine the association between cancer detection rates and needle biopsy rates.
RESULTS: The models show and quantify the diminishing returns for prevalent screens with increasing biopsy rates. A biopsy rate increase from 10 to 20 per 1,000 increases the cancer detection rate by 2.13 per 1,000 with four extra biopsies per extra cancer detected. Increasing the biopsy rate from 40 to 50 per 1,000, increases the cancer detection rate by only 0.25 per 1,000, with 40 extra biopsies per extra cancer detected. Although diminishing returns are also seen at incident screens, screening is nucleotides generally more efficient.
CONCLUSIONS: Increasing needle biopsy rates leads to rapidly diminishing returns in cancer detection and a marked increase in non-malignant/benign needle biopsies. Much of the harms associated with screening in terms of false-positive recall rates and non-cancer biopsies occur at prevalent screens with much lower rates at incident screens. Needle biopsy rate targets should be considered together with recall rate targets to maximise benefit and minimise harm.
2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
* Guarantor and correspondent: R. G. Blanks, Cancer Epidemiology Unit, Nuffield Department of Population Health, Oxford University, Richard Doll Building,