London is still the lowest region in the country for uptake rates of breast screening despite a recent increase, according to NHS data.
The number of eligible women in London in the 53 to 71 age range screened in 2024 was 561,163 (62%), compared to 497,685 (56%) in 2023.
The statistics, released on February 18, also reveal that London was the region with the lowest uptake rates in the country for 2023-24, compared to the West Midlands, the second-lowest at 69%.
The acceptable level of coverage for breast screening is 70% and above.
However, Bexley, Bromley, Havering, Kingston Upon Thames and Sutton were the only areas which reached the level out of all 32 boroughs in London.
Meanwhile, Kensington and Chelsea stood out as having the lowest coverage in the whole of England at 46%.
An NHS report stated: “London has the lowest cancer screening participation (uptake and coverage) rates in the country.”
Raising awareness
Women ed with a GP will be automatically invited for their first NHS breast screening between the ages of 50 and 53, then every three years until their 71st birthday – women aged 71 and over can self-refer.
Earlier this year, the NHS in London launched an awareness campaign ed by charity Breast Cancer Now, to encourage more women to attend breast screenings and to help detect cancers sooner.
Nina Barough CBE was diagnosed with breast cancer in 1996, after discovering a lump while she was in the shower and had to undergo a mastectomy, breast reconstruction, radiotherapy and Zoladex injections.
In that same year, she founded the cancer charity Walk the Walk, known for the iconic MoonWalk London. It is an annual event where thousands of people wear decorated bras or brightly coloured bra t-shirts and walk an overnight half or full marathon through London to raise money and awareness for vital cancer causes.
Barough said: “They thought that I’d had my tumor for about three years and it was quite aggressive
“Looking back there were very minor symptoms which I didn’t recognise at the time.
“I think that’s the thing with breast cancer – it’s not something that you are aware of and by the time you do become aware it’s quite advanced.
“I think that the screening programme is very successful and picking up more and more people earlier which is fantastic.
“What it means is that we need to help that percentage of women who for whatever reason are not going and taking advantage of it.”
Getting screened after receiving an invitation
In 2023-2024, the number of women receiving an invitation and then getting screened was lower, at 1.75million compared to 1.93million in 2022-23.
However, breast screening services were impacted by disruption from the Covid-19 pandemic between 2020-21 and 2022-23.
But it does seem to be bouncing back as breast screening uptakes in first and all routine invitations for the whole of England was 70% for 2023-2024.
NHS England refers to uptake as the proportion of eligible women who have a technically adequate screen within six months of the date of the first offered appointment.
In London, only the Outer North East reached 70%, while other areas fell below the acceptable coverage level.
In addition, figures show more than four in ten women (46%) invited for their first screening are still not acting on their invitation.
Misinformation can put women off screening
Misconceptions are one of several factors which can influence women when they are deciding to get screened.
Retired breast cancer surgeon Dr Liz O’Riordan stated some of the common misconceptions associated with screening are over-diagnosis and false positives and the harm they can cause, social media posts saying mammograms don’t work and cause cancer, and articles in the media from doctors who believe that the screening program should be stopped.
Dr O’Riordan said: “Every woman needs to understand the real facts – how many harmed, how many helped, and how many lives saved.
“Most women will have normal mammograms.
“Don’t judge something you haven’t had, it might not be as bad as you think.”
Real experiences
London resident Sarupa Shah gets screened on an annual basis, due to previously being diagnosed with breast cancer during the Covid-19 pandemic in 2020.
She said: “Screening is a necessity and it’s great that we get it but it’s such a cold experience.
“The rooms are always cold and I don’t think they really think about the patient experience.
“Also, I don’t think people talk about the mammogram experience enough because it’s horrific and it hurts.”
Former teacher Angela Burke added inflexibility with appointment times is the reason why she doesn’t get screened regularly.
She said: “When I ed the screening authority to try to rearrange an appointment made for me, I was made to feel as if I were being difficult and ungrateful.
“When I asked for an appointment during a school holiday, I was told this couldn’t be guaranteed and I’d have to keep calling back, as appointments could only be made for a few weeks ahead.
“Classes cannot be left unattended and it’s difficult to make phone calls during the working day to try to make an appointment.
“On numerous occasions when I attempted to call there was no answer. For these reasons I missed several invitations to attend screening.
“I appreciate that resources are scarce and there’s pressure to ensure all screening appointments are filled but my feeling is that patients are seen as numbers to be processed.
“Not all women, including myself, feel comfortable having screening in a mobile unit in a supermarket car park.”
Shah echoed Burke’s comments.
She said: “It felt a bit weird walking into a mobile unit in a car park.
“I’m all for trying to make it accessible, but I just find that whole experience a bit strange.”
Improving services
As part of efforts to increase breast screening, the NHS is rolling out a new ping and book service.
Through the NHS App, women will receive phone alerts to remind them they are due or overdue an appointment, with new functionality being developed to allow screening to be booked directly through the app.
The Department of Health and Social Care is also looking into the use of AI in breast cancer detection.
Across the UK, 700,000 women will take part in a trial to see how the latest AI tools can be used to catch breast cancer cases earlier.
At present, mammograms require two specialists, while the AI technology enables just one to complete the same process safely and efficiently.
If successful, the trial could free up hundreds of radiologists and other specialists allowing more patients to be seen, tackle rising cancer rates, save more lives and reduce waiting lists.
Anyone who has been affected by this report or requires more information can visit the breast screening page on the Cancer Research UK website.
Feature image source: National Cancer Institute on Unsplash
the discussion