Evaluation of different models of stratified breast screening policies in terms of public health impact and demands on resources

Project theme: Methods development

There are challenges of capacity facing the NHS Breast Screening Programme, at the same time as awareness of breast cancer risk, notably familial and genetic risk, is higher than ever. A number of systems of stratified screening involving either less intensive surveillance for those at low risk or more intensive for those at high, or both, have been proposed.

Our aim is to identify cost-effective stratified breast screening regimens which cope with projected restrictions in staff capacity but continue to deliver a substantial public health benefit.

The project has three stages:

  1. Reviewing published economic models which evaluate the cost-effectiveness of breast cancer screening strategies.

  2. Reviewing clinical evidence to inform the likely effect of different screening regimens on different risk groups in terms of clinical outcomes.

  3. Informed by the findings of stage one and two, developing an economic model to assess the cost-effectiveness of alternative stratified breast screening regimens in the UK.

Project team

Ben Kearns, Harry Hill, Olena Mandrik, Rachid Rafia and Stephen Duffy (Cancer PRU).


Harry Hill


Hill H, Kearns B, Duffy S, Pashaya N, Sasieni P, Offman J (2022) Estimating the cost-effectiveness of risk stratified breast cancer screening in the UK. Policy Research Unit in Economic Evaluation of Health and Care Interventions. Universities of Sheffield and York. Report 066.