Our review of the new Women's Health Strategy for England and how it might impact people affected by breast cancer.

In July the government published the Women's Health Strategy for England. Although women in the UK on average live longer than men, they spend more time in poor health. The strategy aims to address this by tackling the issues women face in accessing care, with cancer being a stated priority.

In the UK, breast cancer is the most common cancer in women, with one woman diagnosed every 10 minutes, and it is a leading cause of death in women under 50. This means better support and care for breast cancer patients is central to improving the health of women across England.

Breast Screening

The NHS Breast Screening Programme prevents 1300 breast cancer deaths each year across the UK, but screening attendance has now reached an all-time low of 62% in England.

The Women’s Health Strategy aims to increase uptake by making screening more accessible and convenient. To support this 25 new mobile screening vans will be used to screen women in areas which are struggling to recover from the impact of COVID. Screening attendance will also be encouraged through text reminders and following up with people who don’t book an appointment when they’re invited.

Almost one million fewer women in England were screened for breast cancer in 2020/21 compared to the year before, so it’s encouraging to see improved screening uptake included in the Strategy. We also welcome the government’s investment in research to help understand why women from some backgrounds are less likely to undergo screening and more likely to be diagnosed late.

However, these actions alone will not be enough to find the estimated 8000 women who are living with undiagnosed breast cancer due largely to the disruption to breast screening caused by COVID over the last two years. That is why we’re calling on the Government to create a plan to address the screening shortfall as part of our #NoTimeToWaste campaign.

Family History

The Women’s Health Strategy commits to improving women’s awareness of cancer risk factors, including altered genes like BRCA, which increase the chances of developing breast cancer. Women with a strong family history of breast cancer should be screened earlier and more regularly, and it is encouraging to see the Strategy promote this service, along with the potential to make screening more targeted and personalised in the future. This approach is already being tested out in women with Jewish heritage, who have a higher risk of BRCA mutations and will soon have access to genetic testing through the NHS.

While this work holds a lot of potential to improve breast cancer prevention and early diagnosis in the future, we know that right now the support and screening services that are offered to women at increased risk of breast cancer is very different across England. That’s why Breast Cancer Now is working with the All-Party Parliamentary Group on Breast Cancer to look at family history services and how they can be improved as part of the group’s ongoing inquiry into breast screening.

Breast reconstruction

During the first wave of the pandemic, many women who underwent a mastectomy had their breast reconstruction disrupted including delays and cancellations as planned operations were paused. We estimate that between March-July 2020, over 1,500 women missed out on reconstruction, and due to COVID disruption, many are now facing longer waits for surgery.

We know that these delays have a profound impact on affected women’s wellbeing, which is why we are glad to see the Strategy reiterate that there should not be any time limits put on reconstructive surgery, and instruct services to provide breast reconstruction for those women who were unable to have it during the pandemic.

While this is welcome progress, some women already faced problems accessing breast reconstruction before the pandemic, and it’s important that action is taken to improve as well as recover these services. Breast Cancer Now is committed to increasing awareness of this issue and working with others to improve access and support for women undergoing reconstruction.

Secondary breast cancer diagnosis

It often takes longer for women with secondary (metastatic) breast cancer to get diagnosed, as common symptoms like unexplained weight loss or extreme tiredness do not point to one type of cancer. The Women’s Health Strategy highlights new non-specific symptom pathways which are being introduced to coordinate testing and speed up diagnosis for conditions with vague symptoms like secondary breast cancer. It also highlights secondary breast cancer as an area where they will be encouraging more research and clinical trials to create better diagnostic tests and treatments.

The Strategy also references the upcoming audit of secondary breast cancer, which Breast Cancer Now and our supporters campaigned for. The audit will form part of a wider programme also covering primary breast cancer, and will provide us with accurate figures on the number of people living with secondary breast cancer in England for the first time. This will give us the insight needed to show how secondary breast cancer care varies across England, and help improve people’s access to treatment and support in the long-term. In our podcast on this topic, we explain more about why it’s so important and hear from two of our supporters, Claire and Jen.   

We are working hard to improve the lives of people affected by breast cancer, but there is always more to be done. By sharing how breast cancer has affected your life and campaigning with us, you can help us continue this work. - https://breastcancernow.org/get-involved/campaign-us