Background: The interpretation of screening mammograms is influenced by factors such as reader experience and their annual interpretative volume. There is some evidence that time of day can also have an effect, with better diagnostic accuracy for readings conducted early in the day. This is not a consistent finding, however. The aim of our study is to provide further evidence on whether there is an effect of time of day on recall- and breast cancer detection rates. Method: We analysed breast screening data from 222,577 women from the Midlands of England. Data were split into three eight hour periods: 0900-1700, 1700-0100, 0100-0900. Differences in recall- and cancer detection rates were analysed using multilevel logistic regression models. Results: Recall rates were lowest for mammograms read between the 1700-0100 time period. Cancer detection rates were lowest during the 0100-0900 time period. Conclusions: Our findings suggest that there are fluctuations in recall- and cancer detection rates over the course of the day.
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