ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2026
Implementing a Risk-Stratified National Breast Screening Programme in the United Kingdom: A Model-Based Cost-effectiveness Analysis.
Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Cost-effectiveness of genetic risk-stratified screening for breast cancer in Taiwan.Breast (Edinburgh, Scotland) · 2025Article
- CanRisk-GP protocol: A feasibility study of incorporating proactive multifactorial breast cancer risk assessment into general practice.PloS one · 2025Article
- Risk stratification in breast screening workshop.BMC proceedings · 2024Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundRisk-stratified breast screening, in which women are offered different screening intervals based on their breast cancer risk, has been proposed as a way to improve the benefits of screening in the United Kingdom National Breast Screening Programme (UK-NBSP). The aim of this study was to explore the cost-effectiveness of potential risk-stratified breast screening strategies in the UK-NBSP.
methodsAn existing validated discrete event simulation model (MANC-RISK-SCREEN) was used to evaluate the cost-effectiveness of 3 risk-stratified NBSPs (risk 1, risk 2, and risk 3) compared with the current UK-NBSP, 2-yearly screening, and no screening [lifetime horizon; health service perspective; costs (£; at 2024 prices)]. MANC-RISK-SCREEN was modified to account for bias in risk prediction and allocation to risk categories (risk misclassification). Uncertainty in the results due to model inputs was quantified using probabilistic sensitivity analysis and one-way sensitivity analyses.
resultsAt a cost-effectiveness threshold of £20,000 per quality-adjusted life year, 2-yearly screening was most likely to be cost-effective, followed by a risk-stratified approach whereby women at high risk (>8% 10-year risk) were screened annually and women at moderate risk (5%-8% 10-year risk) biannually. When risk misclassification was accounted for, the ranking of risk-stratified screening strategies improved relative to universal strategies.
conclusionsIf 2-yearly screening is infeasible due to resource constraints, implementing a risk-stratified approach in the existing NBSP in the United Kingdom would be a cost-effective use of healthcare resources. IMPACT: Implementation of risk-stratified breast screening in the UK national screening program has the potential to improve cancer detection at a reasonable additional resource use and cost.
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