Women who miss first breast cancer appointment have ‘40% higher risk of death’

Women who miss their first breast screening appointment have a 40% higher risk of dying from the disease in their lifetime, researchers have discovered.

They found that women who missed their first appointment were also less likely to attend future screenings.

In England, women are invited for breast screening from the age of 50 up to the age of 71. All women should have received a first invitation for a mammogram by the age of 53.

The latest NHS data shows 70% of eligible women were up to date with breast screening as of March 2024, meaning almost one in three were not.

In Scotland and Wales, breast screening is routinely offered to all women aged between 50 and 70.

Mammograms can detect breast cancer early, often before a lump can be felt, which improves the chances of successful treatment and survival.

In the latest study, published in the British Medical Journal (BMJ), experts including from the Karolinska Institute in Sweden analysed data for nearly half a million women across Sweden.

These women all received their first screening invitation between 1991 and 2020 and were monitored for up to 25 years.

After taking account of a range of social, economic, reproductive, and health-related factors, researchers found 32% of women did not attend their first mammogram appointment.

These women were also less likely to attend subsequent screenings and were more likely to be diagnosed with advanced stage breast cancer than those who were screened.

Not attending a first screening was also linked with a significantly higher risk of breast cancer death (9.9 deaths per 1,000 women over 25 years compared with seven in those screened).

In contrast, the 25 year breast cancer rate was similar between groups, suggesting that the higher deaths among those not attending a first appointment reflects delayed detection rather than increased incidence of the disease, the team said.

The researchers wrote: “First screening non-participants had a 40% higher breast cancer mortality risk than participants, persisting over 25 years.

“The increased mortality is mainly due to delayed detection of breast cancer…

“First mammography screening could be a crucial time point for prevention of adverse breast cancer outcomes.

“If early screening behaviour is predictive of later stage diagnosis and mortality risk, it could provide a valuable opportunity to identify populations at high risk decades before adverse outcomes occur.”

US researchers wrote a piece to accompany the research. They said “the decision to attend that first appointment is far more than a short-term health check – it is a long-term investment in breast health and survival”.

Claire Rowney, chief executive at Breast Cancer Now, said: “Despite breast screening being the most effective way to find breast cancer early, when survival is highest, thousands of women in the UK continue to miss out on this vital health check and those who miss their first appointment are much less likely to go in future.

“With a worryingly high number of women in the UK not attending their first breast screening appointment, we urgently need to ensure women are encouraged to get screened, and that screening is easily accessible to all invited.

“That’s why governments across the UK must drive progress towards delivering the 80% uptake target.

“Maximising the number of women attending breast screening will be a game changer in helping to ensure more breast cancers are diagnosed early and more lives are saved from this devastating disease.”