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Local national health service breast cancer screening programmes in England are replacing their current analogue (film) systems with digital systems (direct digital mammography—DDM). As at October 2011, 67 (83.7%) of the 80 local programmes had at least one DDM X-ray set, and 33 (41%) were fully digital. Local programmes have been advised to implement direct digital as quickly as possible as the independent Advisory Committee on Breast Cancer Screening (has said that running both film and digital systems together is inefficient. 13 programmes (16%) are still to implement digital mammography.