Today’s latest Breast Screening Performance data for 2021-22 reveals that the percentage of women taking up their invitation to breast screening in England is still worryingly below pre-COVID levels, and over one million women missed out on vital breast cancer screening last year.*
While 3.2 million women were invited for routine breast screening in England in 2021/22, only 2.1 million were actually screened. The proportion of women taking up their invite remains at historic lows for the second year running, with only 62.3% of women invited attending breast screening, which is a less than 1%-point improvement from attendance in 2020/21 (61.8%). The increased number of invites issued last year included delayed invitations to women who were not offered screening in 2020/21 due to disruption caused by the pandemic. However, NHS England are yet to clear this backlog, despite their target to do so by March 2022.
Concerningly, screening attendance has been detrimentally impacted by changes made to the breast screening programme during the recovery period, namely the switch to an open invite system, which has made it harder for women to arrange and attend screening.
The sustained drop in uptake also comes after a decade of steady decline in screening attendance pre-COVID. Years of underinvestment and neglect have left the breast screening programme in a fragile state, without the resources needed to meet increasing demand. But the dire state of breast screening in England was not an inevitability; too many opportunities to modernise and improve the programme have been missed, and the investment provided has been too little, too late.
Breast screening is a key tool for detecting the disease early, and critically, the sooner it is diagnosed, the more likely treatment is to be successful. That 6,364 fewer breast cancers have been found through screening in the two years since COVID, compared to the same period pre-pandemic, is deeply concerning.
Commenting on the latest data, Chief Executive at Breast Cancer Now, Baroness Delyth Morgan, said:
“Today’s data starkly depicts the crisis surrounding the NHS Breast Screening Programme’s performance.
“Breast screening is a vital tool for detecting breast cancer early and this is crucial as the sooner it’s diagnosed the better the chance of treatment being successful. Furthermore, while record numbers were invited to routine breast screening in 2021/22, the frightening reality is that the proportion of women taking up their invite remains at a historic low for the second year running, meaning over one million women missed out on screening.
“Once an NHS success story, the Breast Screening Programme is now chronically underfunded and overstretched. Our incredible NHS staff continue to go above and beyond to provide the best standard of care for breast cancer patients, but women will continue to be denied the best chance of timely breast cancer diagnosis and treatment until the government shows it’s serious about fixing the screening programme. This means taking decisive action to remove barriers to screening, ring-fence investment, fill workforce gaps and bring the programme into the 21st century to guarantee women’s right to accessible, equitable and effective breast screening.
At Breast Cancer Now, we have heard from women that they have been unable to reach their local breast screening service to book an appointment or have been told no appointments are available.
Significant health inequalities in early breast cancer diagnosis rates also see women living in highly deprived areas, and from certain minority ethnic backgrounds, at much greater risk of late diagnosis*. The groups are also less likely to undergo regular breast screening, which is one of the issues driving these disparities. Today’s figures reveal that uptake for women invited to their first screening in London was only 35%, which is down from the previous year of 45%. And in the East of England uptake for first screening invites was 52.1%, which is down from 56.2% last year.
Reducing inequalities in screening uptake is a clinical priority for NHS health improvement work that needs urgent action.
Baroness Delyth Morgan continues:
“The government can no longer sidestep its responsibility for fundamental failures in breast cancer screening performance in England. Women have the right to access breast screening that could save their lives from breast cancer. But increasingly, access is being undermined, with no proper acknowledgment or meaningful action from the government. It must take urgent action to recover standards, and set out a concrete plan to tackle the programme’s underlying issues and prepare breast screening for the future.”
Today, Breast Cancer Now’s Vice President Dame Baroness Joan Bakewell, and charity ambassador and presenter Julia Bradbury, are fronting Breast Cancer Now’s petition to fix breast screening, as part of the charity’s #NoTimeToWaste campaign. They are asking the public to sign this petition calling on the government to invest in the long-term future of the programme and guarantee women’s access to breast screening, by transforming the programme into a service that is convenient, equitable, and able to evolve.
Dame Baroness Joan Bakewell, Vice Patron of Breast Cancer Now, said:
“I’m extremely proud to front Breast Cancer Now’s petition to save breast screening, and save women’s lives from breast cancer.
“I have no doubt that had my sister Susan been diagnosed with breast cancer earlier, she would not have tragically lost her life to the disease in her fifties. The launch of routine screening revolutionised early detection of breast cancer, helping to ensure people diagnosed with the disease could start treatment sooner and have a better chance of treatment being successful; ultimately helping to avoid the heartache my family and I endured when my sister died from breast cancer.
“But despite there now being capacity for this to happen, screening uptake is at an all-time low, meaning too many women are walking around today with undiagnosed breast cancer.
“Having had my own recent experience of cancer, I know first-hand the importance of early diagnosis. The backlog must be addressed, those without a diagnosis must be seen, and women’s’ lives must be saved from the disease. Please sign Breast Cancer Now’s petition now to help make sure this happens.”
Julia Bradbury, Supporter for Breast Cancer Now, said:
“Receiving a breast cancer diagnosis was one of the most terrifying moments of my life. But being diagnosed at a late stage and being given a poorer prognosis that could have been avoided is something I can’t imagine.
“It breaks my heart that so many women who missed out on screening during the pandemic are still yet to attend. “We must do better for people, and Breast Cancer Now’s #NoTimeToWaste campaign is delivering such a vital message to government to save the breast screening programme – please join me in supporting this campaign today by signing the charity’s petition and help save breast screening and ultimately women’s lives from breast cancer.”
To sign Breast Cancer Now’s petition urging the government to invest in guaranteeing women’s access to breast screening – now and for the future, visit: https://petition.parliament.uk/petitions/632824
For more information or to arrange an interview, please contact the Breast Cancer Now press office at firstname.lastname@example.org or on 07436 107914.
Balwinder Nanray from east London was diagnosed with an aggressive form of breast cancer in August 2015 following a routine mammogram. She was 52 and had no symptoms before her screening but required immediate surgery and extensive treatment following her diagnosis. She said: “I’m proof of why it’s so important that women are screened on time, because the earlier breast cancer is caught the easier it is to treat and the better the outcomes.
“Sadly, there is still a lack of understanding and a real stigma around breast cancer in underrepresented communities. A lot of women feel ashamed and embarrassed at the thought of getting a diagnosis, but they shouldn’t be. We need to increase awareness of the importance of screenings, so everyone gets the chance to be treated early.”
Notes to editor
Over one million women missing out on vital breast cancer screening last year: Breast screening routinely offered to women aged 50 to their 71st birthday. In 2020/21, 3,168,637 women were invited, with 2,060,729 screened. This results in 1,107,908 women missing out on screening. For women aged 45 and over, from all routes including invites, GP-referral and self-referral as well as short-term recalls, 3,227,895 women were invited, with 2,202,248 screened. This results in 1,025,647 women missing out on screening.
62.3% uptake refers to the routine invite to screening for women aged 50 to their 71st birthday.
6,364 fewer breast cancers have been found through screening. This figure is the difference in the number of cancers detected for women aged 45 and over between the periods of 2018/19-2019/20 (37,329) and 2020/21-2021/22 (30,965).
Ethnicity and stage at diagnosis. National cancer registration and analysis service data briefing. (2016). Public Health England and Cancer Research UK. Office for Health Improvement & Disparities. “PHE Screening Inequalities Strategy.” GOV.UK, 22 Oct. 2020, www.gov.uk/government/publications/nhs-population-screening-inequalities-strategy/phe-screening-inequalities-strategy. Accessed 13 Feb. 2023