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Advocating in Parliament for increasing the uptake of breast screening to drive early diagnosis

Today, Steve Brine MP tabled a ten minute rule bill on how breast screening can increase early diagnosis. In this blog we take a look at some of the issues covered by the bill and why they are so important.

As a Breast Cancer Now Ambassador and former Cancer Minister, we appreciate him raising such a vital and urgent issue in Parliament.

What is a Ten Minute Rule Bill?

A ten minute rule bill gives MPs the opportunity to raise awareness of a specific issue and increase political support for the changes they are proposing. MPs can make speeches of no more than 10 minutes outlining their position, which another MP may oppose in a similar short statement.

A minority of ten minute rule bills become law but, by creating publicity around an issue, they may affect legislation indirectly.

This particular bill focuses on improving uptake of invitations to the NHS breast screening programme, including amongst women from groups less likely to attend screening, and offering screening to all women at increased risk of breast cancer because of their family history.

This will help ensure more breast cancers are diagnosed as early as possible, when treatment is more likely to be successful.

Improving uptake of breast screening

Uptake of breast screening has been falling over the last decade, but the disruption caused by the pandemic has accelerated this decline.

In March 2020, routine breast screening of women aged 50-70 was paused due to COVID. Although screening was restarted over the summer of 2020, social distancing and infection prevention measures reduced the number of appointments available.

Despite the tireless work of NHS staff, this has led to over 936,000 fewer women in England being screened for breast cancer between April 2020 and March 2021 compared to the previous year.

The proportion of women who attended their screening appointment when invited also dropped dramatically, with only 62% of women invited taking up the offer. Screening attendance was even lower amongst women who were being invited to screening for the first time - only 54% - which is even more concerning, as women who do not go to their first screening are much less likely to attend future appointments.   

Finding effective methods of encouraging attendance

An estimated 8,930 women are currently living with undiagnosed breast cancer in England due to pandemic disruption, the majority of whom will be waiting for screening. If we are to find these women, we must reduce the shortfall in the number of women screened, which will require much higher levels of screening uptake.

But we are concerned that some of the measures taken to help the screening programme recover could be contributing to the drop in the number of women attending screening.

For example, when breast screening restarted, most women were sent ‘open invites’, which required them to ring up to arrange their own screening appointment. Before the pandemic, invitations provided a timed appointment for screening within the letter women received.

Previous research suggests women are less likely to attend screening when sent open invites. It’s crucial that we fully understand the impact switching to an open invite model could have on uptake, especially for women that are already less likely to attend breast screening, before long-term decisions are taken on a future invitation model for the programme.

Reducing health inequalities

Of particular importance to this bill is improving uptake in groups less likely to attend screening.

Research shows that women living in areas of high deprivation and women from some ethnic minority backgrounds are less likely to attend breast screening and are also at higher risk of having breast cancer diagnosed at a later stage.

It is vital that screening teams have more data on health inequalities so they have the knowledge and tools needed to address the disparities in breast screening which existed before the pandemic.

The success of the screening programme in increasing early diagnosis relies on women from all backgrounds being aware of and informed about breast screening, and able to access it in a convenient and timely way. This can only be achieved through proactively identifying and removing barriers that make it harder for some women to take up the offer of breast screening.

Women at increased risk because of their family history

The bill also looks to ensure women who are identified as being at an increased risk of breast cancer are able to access screening that reflects their increased risk and gives them a better chance of being diagnosed early.

It’s recommended that women with a strong family history of the disease undergo screening earlier and more frequently. But in practice, increased screening is not consistently available to all those affected, often due to limited budgets within local services.

A review of screening services in 2019 made recommendations that would help address this, but most of these have yet to be implemented. It is vital that steps are taken to ensure that these women are able to consistently access the screening which is recommended for them.

How to get involved

Increasing awareness and building political support for our efforts to improve the lives of people affected by breast cancer is a key part of how we deliver meaningful change.

You can find out more about our previous achievements and get involved in our current campaigns by becoming a part of Breast Cancer Now’s Campaigns Network.

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