Briefing on breast cancer screening in EnglandS

Over the course of the past 2 years, the All-Party Parliamentary Group (APPG) on Breast Cancer has conducted an inquiry into the state of the NHS’s breast screening programme in England.

We’ve produced a briefing which outlines the key insights and recommendations for ensuring the efficiency and future success of the programme.

Read the briefing in full.

Over 3 million women are eligible for breast screening in England every year. And a third of all breast cancers in women are found through the national screening programme.

It’s estimated that in the UK, around 1,300 breast cancer deaths are prevented every year as a direct result of the work the programme does.

The briefing outlines the key insights and recommendations from the APPG’s inquiry for ensuring the efficiency and success of the breast screening programme.

We’re particularly concerned with the progress in recovering the programme’s performance and the unintended consequences of recovery decisions on uptake and health inequalities.

We also investigate the potential opportunities to improve family history services and screening for women who’re at increased risk of breast cancer.

And we examine how the programme needs to change to ensure it’s fit for the future.

This inquiry has found that there’s a real opportunity to radically improve the breast screening programme by harnessing the full potential of new innovations.

But any future successes will depend on changes and investments being made now.

The challenges this inquiry has identified have to be addressed as a matter of urgency.

We urge the government to recognise the critical need for transformation. To provide the change needed to make these recommendations a reality, the government should:

1. Set out the immediate actions that’ll be taken to help mitigate the damage the pandemic has done to uptake.
   This includes delivering a national awareness campaign to promote breast screening, focusing on areas and communities where uptake is lowest.
2. Make breast screening uptake a core focus of their work on health inequalities.
   That includes making attending breast screening easier by offering more routes and opportunities to access that screening.
3. Work with the National Screening Committee (NCS) and NHS England to deliver breast screening for all at-risk women through the national screening programme.
4. Approve funding for, and start the implementation, of the Digital Transformation of Screening (DToS).
   Ensure that the IT improvements can deliver a targeted programme and accommodate new tools being introduced into the screening pathway.
5. Work with NHS England to produce an ‘horizon scanning’ report on how breast screening is likely to evolve over the next decade. This should include both IT and long-term workforce planning. Consideration will need to be taken as to how expertise is likely to change, and training will need to be expanded to meet this need.

The latest NHS England screening data, published on 30 January, reveals breast screening uptake remains well below its target for a 4th consecutive year.

Only 64.6% of women invited took up their breast screening appointments in 2022/23. While a small improvement, this remains worryingly below the NHS minimum 70% target, as well as the 80% achievable target.

If the achievable target had been met, 458,073 more women would’ve been screened, and we estimate that 3,758 more breast cancers would’ve been found.

That only 64.6% of women in England took up their first screening invite is also a particular concern. That’s because women who don’t attend their first screening are much less likely to attend when they’re next invited.

A new report published on 22 January by cross-party think tank Demos and ourselves, on ‘The Cost of Breast Cancer’, also reveals that breast cancer will cost the UK economy as much as £2.6 billion to £2.8bn in 2024, rising to £3.6bn by 2034. That’s if nothing changes in the next decade.

The report shows that by increasing screening uptake from 2019 rates to 80%, an achievable target, we’d see a net cost saving to the UK economy in the range of £96m to £111m in 2034, and wellbeing cost savings of £1.2bn.

This cost saving ultimately comes from more people being diagnosed at stage 1 (where survival is almost 100%) and fewer at stages 2 and 3.