Fund breast cancer screening from the age of 40

Currently women are invited for a breast cancer screening mammogram between the age of 50-53. I would like the Government to provide funding to support breast cancer screening being offered from the age of 40.

I am a 46 year old mother of 4. In July 2023 I was diagnosed with breast cancer. Due to my type of cancer and the position I never would have been able to feel a lump. My cancer was found by chance, after investigation of something else. The situation worsened when tests showed my cancer had metastasised to my bones. If I had had a routine mammogram at 40 years of age or even 43 I wouldn't now be living with advanced cancer and dying sooner than I should. Many women like myself could be saved.

The Government is committed to reducing lives lost to breast cancer. DHSC recognises that breast cancer can be a devastating disease affecting people of all ages and appreciates efforts to raise the profile of the importance of screening.

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.

We currently do not routinely 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 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.

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. The Marmot Review can be read in full 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) – the independent scientific committee which advises Ministers and the NHS in all four countries of the United Kingdom 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 (for example due to family history) screening earlier and more often.

The remit of the UK NSC was expanded in 2022 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 it is currently considering the evidence.

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.

There is currently a trial called AgeX looking at the impact of increasing and/or decreasing the screening age for the breast screening programme. When the results from this trial are available, they will give a better understanding of the benefits and harms of widening the age range.

Changes to a screening programme can be submitted to the committee for consideration via the annual call. The next one opens in July 2024, as set out here: 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: https://www.nhs.uk/conditions/predictive-genetic-tests-cancer/

Department of Health and Social Care