Women who skip their first breast cancer screening appointment face a 40% higher risk of dying from the disease, according to new research.
Scientists at the Karolinska Institute in Sweden analysed data from about 500,000 women invited to their first screening between 1991 and 2020, with results published in the British Medical Journal. They found that nearly one in three (32%) did not attend their first mammogram and were more likely to be diagnosed at a later stage and die from breast cancer over the next 25 years.
The study showed breast cancer mortality was 9.9 deaths per 1,000 women among those who skipped their first screening, compared with seven deaths per 1,000 among those who attended. Importantly, overall cancer rates were similar between groups, indicating delayed detection – not higher incidence – was driving the worse outcomes.
“First screening non-participants had a 40% higher breast cancer mortality risk than participants, persisting over 25 years,” the researchers wrote, noting that early screening behaviour could help identify at-risk populations long before advanced disease develops.
In an accompanying editorial, US researchers said the findings highlighted how attending a first screening was “far more than a short-term health check”, describing it as “a long-term investment in breast health and survival”.
In England, women are invited for breast screening from ages 50 to 71, with the first invitation sent by 53. However, NHS figures show almost one in three eligible women were not up to date with screening as of March 2024. Claire Rowney, chief executive of Breast Cancer Now, said too many women were missing their first appointment and called for urgent action to improve access and uptake.
The study comes as global cancer deaths are forecast to rise nearly 75% to 18.6m by 2050, with new cases increasing by 61% to 30.5m. Researchers attribute much of this rise to ageing populations and lifestyle-related risks such as smoking, poor diets and high blood sugar.
In more hopeful news, scientists reported progress in pancreatic cancer research. A team publishing in Nature found that blocking a protein known as SPP1 could prevent the most aggressive form of the disease, pancreatic ductal adenocarcinoma, from spreading. Axel Behrens of the Institute of Cancer Research in London said the discovery could lead to new treatments that keep patients “living well for longer”.
