The All-Party Parliamentary Group on Breast Cancer recently launched its new inquiry, A Mixed Picture: An Inquiry into Geographical Inequalities and Breast Cancer.

The APPGBC is calling for written evidence for its new inquiry. Find out about the inquiry and how you can get involved.

While breast cancer patients should receive the same level of treatment, care and support, regardless of where they live, unfortunately this is often not the case.

If you compare performance at Clinical Commissioning Group (CCG) level, there are clear variations across England:

  • Screening coverage varies by 30.7%
  • The percentage of breast cancers detected at stage 1 or 2 is as low as 35.3% and as high as 88%
  • The under-75 breast cancer mortality rate ranges from 13.3 to 31.9 per 100,000 women

The inquiry will aim to understand the extent of these variations – including, where possible, whether variation has changed significantly over time – and the reasons for these variations, as well as exploring the impact they have on patients. Ultimately, the inquiry will make recommendations about how these inequalities can be reduced.

Focus of the inquiry

The inquiry will look at geographical differences in diagnosis, treatment and care, outcomes and NHS structures and plans. More specifically, these will include:


  • The number of women aged 50 to 70 attending screening
  • The number of women diagnosed with breast cancer as a result of presenting as an emergency
  • The percentage of breast cancers diagnosed at early stages
  • The promptness with which patients are diagnosed

Treatment and care

  • How promptly patients receive treatment
  • Access to some treatments, such as bisphosphonates
  • Aspects of care that breast cancer patients particularly value, such as access to a clinical nurse specialist


  • Rates of one-year survival
  • Rates of five-year survival
  • Premature mortality

NHS structures and plans

The inquiry will consider the opportunities presented by recent changes and developments to NHS structures, including:

  • Sustainability and Transformation Plans (STPs) and Cancer Alliances
  • Devolution of health services in Greater Manchester
  • The Cancer Vanguard
  • The availability of data and how it is being used to improve the quality of treatment and care

For more detail about the inquiry, please download the Terms of Reference.

Call for written evidence

The APPGBC is calling for written evidence on geographical inequalities in breast cancer as part of this inquiry. We are keen to hear from organisations and individuals with expertise in, or experience of, breast cancer, including patients, clinicians, commissioners, health bodies and others.

While the APPGBC is a cross-UK group, health services are devolved to each of the nations and data are not necessarily comparable with one another. The inquiry will therefore focus on geographic inequalities within England. However, the APPGBC is keen to learn from examples of good practice in Scotland, Wales and Northern Ireland and therefore encourages representatives in the devolved nations to contribute to the inquiry.

As well as the likely reasons behind geographical differences, we are keen to understand what can be done to help address these. We would therefore like to hear from those in areas that have improved their performance in certain themes, and those that have helped others to improve.

To respond please download the call for written evidence document.

To help you respond to the call for written evidence we have provided some examples of geographical differences in breast cancer by Clinical Commissioning Group (CCG). Links to this data are included in the relevant sections of the call for written evidence. Details about submission are also included in this document.

The deadline for written evidence is 5pm on Wednesday 15 March.

Oral evidence sessions

First Oral Evidence Session

2.00pm - 3.30pm, Wednesday 22 March 2017

Committee Room 16, House of Commons

Second Oral Evidence Session

4.00pm - 5.30pm, Tuesday 25 April 2017

Committee Room 7, House of Commons

Third Oral Evidence Session

2.00pm - 3.30pm, Wednesday 24 May 2017

Committee Room 20, House of Commons

More information

The inquiry was launched at our recent Breast Cancer Awareness Month Reception at the House of Commons. The event was attended by over 100 MPs, Peers, civil servants, health professionals, patients, and charity representatives. You can find out more about the reception here.

Follow us on Twitter @APPGBC or contact for updates on the APPG and the inquiry.

Watch videos from the inquiry launch in October 2016

Mary Huckle, Breast Cancer Now supporter and Patient Representative:

Sharon Hodgson MP, Co-chair of the APPGBC:

Delyth Morgan, Chief Executive at Breast Cancer Now:

Cally Palmer CBE, National Cancer Director of NHS England: