Melanie Sturtevant
Associate director, policy, evidence and influencing, at Breast Cancer NowMelanie discusses the transformation needed within the NHS to deliver top level breast screening, involving greater technological improvements and removing barriers to make it easier for women to access their appointments.
The breast screening programme is one of the NHS’ biggest success stories and has been saving lives from breast cancer for 35 years. However, years of growing demand coupled with disruption caused by the pandemic has pushed the programme to breaking point and put its long-term sustainability at risk.
While NHS screening staff work tirelessly to deliver breast screening, the programme has been chronically underfunded and overstretched for years.
The pandemic exacerbated fundamental challenges in the breast screening programme. Routine screening was paused for several months and the programme has still not recovered. After years of steady decline, the proportion of women taking up their screening invite in England during COVID-19 reached a record low of 62% (in 2020/21). Worryingly, uptake has remained at this low point, with over one million women having missed out on vital breast cancer screening last year (2021/22).*
With breast screening uptake in England the lowest in the UK, the government can no longer sidestep its responsibility for the failures in its performance. The government must show it’s serious about fixing the screening programme. This means taking decisive action to remove barriers and make it easier for women to attend breast screening, ring-fence investment, fill workforce gaps and bring the programme into the 21st century.
Breast Cancer Now has produced a blueprint for how breast screening can be transformed by 2028 – delivering the accessible, equitable and effective breast screening women in England deserve.
Equal access to breast screening is vital. We’ve heard from women who have been unable to reach their local breast screening service to book an appointment or have been told no appointments are available. Women must be given a variety of more convenient and flexible ways to arrange breast screening, including online booking. Education and awareness is also a key part of the solution, which is why we are calling on NHS England to deliver a national media campaign to highlight the importance and availability of breast screening, especially in communities where uptake is lowest.
We must also reduce health disparities when it comes to breast screening. Attendance varies significantly, with women in areas of higher deprivation and from certain ethnic minority communities much less likely to have regular breast screening, putting these women at much greater risk of being diagnosed at a later stage and having lower survival rates. Access to screening can also present challenges for other women including those with disabilities, those experiencing homelessness and LGBTQ+ people. We must address these issues now to improve uptake of breast screening and help eliminate inequalities.
Both the recovery and future of the breast screening programme depend on long overdue IT upgrades. The programme’s current digital systems and equipment are clunky, outdated and prone to failures that put women at risk. Without new systems in place, it will be near impossible to nationally roll out innovations that have the potential to detect more breast cancers earlier and more efficiently, like AI screening tools and personalised risk-based screening. While new IT infrastructure is a significant upfront investment it will deliver crucial improvements and efficiencies that will deliver substantial cost-savings as well as saving more lives from breast cancer in the longer term.
We know the importance of breast screening programme – throughout our #notimetowaste campaign hundreds of women have shared with us their experiences of how screening led to them receiving an early diagnosis of breast cancer, prior to them having any signs or symptoms. Sign our petition now to join us in urging the government to invest in guaranteeing women’s access to breast screening – both now and for the future.
*Read more about Breast Cancer Now’s screening blueprint https://breastcancernow.org/sites/default/files/bcn_report_blueprint.pdf