Scottish Breast Screening Programme: major review

Major review of the Scottish Breast Screening Programme.

Future Population Demand

Future eligible population by age band and Breast Screening Centre

Approach and methodology

Population forecasts were developed for each Breast Screening Centre, and for all Scotland overall. The analysis, given at appendix 7, outlines changes in the overall eligible population (females, 50–70), gives a breakdown by population age band (from age 40 to 71+), and includes population trends for females over 71 years of age.

The methodology employed utilised GP practice population data provided by the primary care team in Public Health Scotland (data from CHI file, GP registered patients, 2018 & 2019), with SBSS Breast Screening Centre lookup by GP Practice code at April 2019, and NRS Health & Social Care Partnership (HSCP) population projections (2019 – 2043).

Change to the eligible population over time

At the outset of this review, the task of examining demand and changes in the eligible population was linked, in part, to tackling programme slippage. The planning assumption stated in review initiation was that the number of women eligible for Breast Screening continues to increase and this will continue for another 10 years.

For the eligible 50-70 population overall this analysis suggests that the next 10 years is a picture of static levels of demand or a small decline in the eligible population for all centres except the South East of Scotland which sees some growth in the eligible population.

Longer term, the all Scotland forecast shows a small reduction in demand (-4.1% over the next 20 years, see table 1 below). Within this, the longer term forecasts show significant reductions in the eligible population in the North of Scotland Breast Screening Centre and the South West of Scotland Centre.

Table 1 – Scotland Projections women age 50-70: Percentage change over time by Breast Screening Centre
Area 10 Year Change (2029) % change 20 Year Change (2039) % change
East of Scotland Breast Screening Centre -1,912 -2.7 -5,824 -8.2
North East of Scotland Breast Screening Centre -353 -0.4 -1,699 -2.1
North of Scotland Breast Screening Centre -1,042 -2.4 -4,607 -10.5
South East of Scotland Breast Screening Centre 7,421 3.7 9,227 4.6
South West of Scotland Breast Screening Centre -3,306 -4.1 -13,201 -16.2
West of Scotland Breast Screening Centre -302 -0.1 -15,618 -5.3
Scotland 508 0.1 -31,722 -4.1

For females in the 50–59-year age bands the ten year forecast shows that all centres will see a significant decrease in the youngest age group for screening, those under 55, and longer term this is sustained in the North of Scotland and South West Centres.

For females in the 60-69 bands, the 10-year estimate shows that all centres see an increase in this bracket.

All centres see a significant increase in the number of women aged 71+ years in their catchment areas (range from 14% to 22% by 2029, and longer-term a minimum of 35% and maximum of 48% increase across centres).

Changes in the proportion of women in the population who are over 71 years have been used to help consider the recommendation on over-age self-referral to breast screening, reported in section 5. Recognition of a static / declining trend rather than a continual increase in demand has informed the work of the review as we have progressed. Workforce planning and commissioning of Breast Screening Centres should have regard to projected population changes by centre reported above.



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