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 aims 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 is examining geographical differences in diagnosis, treatment and care, outcomes and NHS structures and plans. More specifically, these 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

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. For this reason, the inquiry will focus on geographic inequalities within England. However, the APPGBC is keen to learn from examples of good practice in Scotland, Wales and Northern Ireland.

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

Call for written evidence

The call for written evidence for the inquiry has now closed.

More information

The inquiry was launched at our 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 appg@breastcancernow.org 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: