Women who miss their first breast cancer screening appointment have a 40% higher risk of dying from the disease, according to a new study.
Experts at the Karolinska Institute in Sweden analysed data for about half a million women across Sweden, with the findings published in the British Medical Journal. The women all received their first screening invitation between 1991 and 2020 and were monitored for up to 25 years.
After taking into account social, economic, reproductive, and health-related factors, the researchers found almost one in three (32%) women did not attend their first mammogram appointment.
Not attending a first screening was linked with a significantly higher risk of breast cancer death – 9.9 deaths per 1,000 women over 25 years – compared with seven in those screened.
These women were also less likely to attend subsequent screenings and were more likely to be diagnosed with advanced stage breast cancer than those who were screened.
In contrast, the 25-year breast cancer rate was similar between groups. This suggests that the higher death risk among those not attending a first appointment reflects delayed detection rather than increased incidence of the disease, the team said.
The researchers wrote: “First screening non-participants had a 40% higher breast cancer mortality risk than participants, persisting over 25 years.
“If early screening behaviour is predictive of later stage diagnosis and mortality risk, it could provide a valuable opportunity to identify populations at high risk decades before adverse outcomes occur.”
Responding to the study in a linked editorial, US researchers said the results showed attending a first appointment was about “far more than a short-term health check”.
For most women, the first screening appointment is unlikely to result in a cancer diagnosis or signal any areas of concern.
But even just turning up and getting information about how to reduce their risk and what symptoms to look out for can act as “a long-term investment in breast health and survival”, the US researchers said.
Breast screening programme eligibility varies around the world. In England, women are invited for breast screening from the age of 50 up to the age of 71. All women should have received a first invitation for a mammogram by the age of 53.
The latest NHS data shows 70% of eligible women were up to date with breast screening as of March 2024, meaning almost one in three were not.
Claire Rowney, the chief executive of the Breast Cancer Now charity, said “a worryingly high number of women” missed their first appointment. Urgent action was needed to ensure women were encouraged to get screened, and that it was easily accessible to all invited, she added.
Separate research showed the annual global cancer death toll was forecast to rise by nearly 75% to 18.6m by 2050. New cases are expected to rise 61% in the next 25 years to 30.5m, according to the study published in The Lancet.
A global team of researchers said the trend was mostly a result of population growth and an increasingly ageing population.
But they also said 42% of cancer deaths were linked to risks that could be modified, including smoking, unhealthy diets, high blood sugar and exposure to toxins.
In more hopeful news, it emerged on Wednesday that scientists have uncovered a target for drug treatments that could stop pancreatic cancer in its tracks.
Researchers looked into the most aggressive and most common form of this cancer, pancreatic ductal adenocarcinoma (PDAC).
They found in a series of experiments that blocking a protein, known as SPP1, could stop the spread of the cancer and increase survival time. The findings, published in the journal Nature, could lead to medicines targeting the protein.
Axel Behrens, a professor of stem cell biology at the Institute of Cancer Research in London, said the team had “identified a protein that, when blocked, can prevent cancer from spreading around the body and can hopefully keep patients living well for longer”.
The next step will be to develop a drug that can precisely target the protein, he said.
