Fund routine breast cancer screening from the age of 25

Women under 50 should be able to access routine breast cancer screenings. Further tests can then be arranged as necessary, so that breast cancer is identified as early as possible, to maximise the chance of successful treatment and survival.

I am 33 and I have been diagnosed with grade 3 invasive triple negative breast cancer. The first I heard of early screening options was in the cancer clinic waiting room on my diagnosis. I believe this is utterly unacceptable.

Just because young women have denser breast tissue and are at a lower risk does NOT mean they should not be getting screened, to enable an early diagnosis, and better prognosis and chance of survival.

DHSC recognises breast cancer can be a devastating disease affecting people of all ages. According to Cancer Research UK, between 2016-18 there were around 55,920 new cases of breast cancer each year in the UK and in England, 76% survived 10 or more years between 2016-18.

Owing to cutting edge treatments and faster detection breast cancer survival rates are improving, last year more than a million breast cancer scans were carried out saving an estimated 1,300 lives.

We have increased funding by £10 million to provide 28 new mobile breast screening units as well as over 60 life-saving upgrades to services in the areas where they were most needed.”

The NHS Breast Screening Programme offers all women in England between the ages of 50 and their 71st birthday the opportunity to be screened every three years for breast cancer, to help detect abnormalities and intervene early to reduce the number of lives lost to invasive breast cancer.

We currently do not screen women younger than the age of 50 due to the lower risk of women under this age developing breast cancer and the fact that women below 50 tend to have denser breasts; The denseness of breast tissue reduces the ability of getting an accurate mammogram, the accepted screening test for breast cancer.

The 2012 UK independent review of breast cancer screening (the Marmot review) found little evidence to show that regular mammograms for women below the current screening age would result in reduced deaths from breast cancer. The Marmot review also found that screening women outside the ages of 50-70 years could lead to over-diagnosis (referring women for unnecessary tests) and over-treatment (operating on women with disease which is unlikely to cause serious harm to them).

Not all breast cancers can be detected early when they are non-invasive, and some women with non-invasive disease would never develop cancer during their lifetime. Abnormalities that would never have developed into a cancer would be found and treated, potentially causing unnecessary harm and anxiety.

Breast screening is currently offered from age 50 because the chance of developing breast cancer increases with age: four out of five breast cancers develop in women over 50. The Marmot review estimated that inviting women aged 50-70 reduces mortality from breast cancer in the population invited by 20% and saves an estimated 1,300 lives a year. You can read the Marmot Review here: http://www.cancerresearchuk.org/prod_consump/groups/cr_common/@nre/@pol/documents/generalcontent/breast-screening-report.pdf

National screening programmes are recommended by the UK National Screening Committee (UK NSC), which is an independent scientific committee which advises Ministers and the NHS in all four countries on all aspects of screening and supports implementation. It is only where there is evidence to show that offering screening does more good than harm, that a screening programme is recommended.

NHS England offers women with a very high risk of breast cancer (e.g. due to family history) screening earlier and more frequently. The UK NSC is aware of the growing concerns expressed by both clinicians and members of the public about how people with moderate and high risk of breast cancer are screened. Last year the remit of the UK NSC was expanded to include targeted, and risk stratified screening, in addition to population screening. So far, the UK NSC has not made a recommendation for targeted screening of women at a moderate or high risk of breast cancer but is currently considering evidence in favour of risk stratification for these women.

The UK NSC recognises that screening programmes are not static and over time may need to change to be more effective. They are constantly assessing the latest evidence, including when new evidence is published which brings into question a current recommendation and change their advice accordingly. Changes to a screening programme can be submitted to the Committee for consideration via the annual call: UK NSC’s next annual call for topics will open on 1 July 2024 - UK National Screening Committee (blog.gov.uk) https://nationalscreening.blog.gov.uk/2023/08/15/uk-nscs-next-annual-call-for-topics-will-open-on-1-july-2024/

Anyone who believes that they have a family history of breast cancer and does not receive breast screening earlier or more frequently, should speak to their GP for advice on how to be referred to a specialist for genetic testing. Further details can be found here: Predictive genetic tests for cancer risk genes - NHS (www.nhs.uk) https://www.nhs.uk/conditions/predictive-genetic-tests-cancer/

Department of Health and Social Care