Women’s lives are at risk when they have to book their own mammograms as evidence shows thousands of essential breast cancer screenings are being missed.
Before the pandemic, all women had mammography appointments with a set date and time.
But the NHS now recommends “open invitations”, which require women to call and make their own appointment.
Now a study shows the worrying impact of missed appointments, which the charity Breast Cancer Now fears could be a “key reason” for the massive drop in the number of women being screened.
The first major study of policy change, carried out by Queen Mary University of London in collaboration with NHS England, involved almost a quarter of a million women in London.
Before the pandemic, all women had mammography appointments with a set date and time
It found that women were 14 percent more likely to show up for a mammogram if they had a date and time appointment than an open invitation.
Around 12,000 women in London are estimated to have missed a breast exam because of open invitations – in just seven months.
The study did not look at the whole country, but based on the results, around 100,000 women a year in England may miss a mammogram.
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Baroness Delyth Morgan, chief executive of Breast Cancer Now, said: “We are deeply concerned about the impact of open invitations on the uptake of breast appointments.
“We are concerned that this change may be a key reason for the drastic decline in adoption.
“In 2020-21, just 62 per cent of women in England responded to invitations to have a breast examination, the lowest level on record.”
Professor Gareth Evans, an expert on breast cancer screening from the University of Manchester, said: “The open invitation policy should be reversed to encourage scheduled appointments for all women invited for a mammogram.
“Health psychology shows that people who are asked to come to an appointment at a certain time are more likely to attend.
“If they have to make an appointment themselves, they probably won’t make it.
“That’s why the turnout is so low.”
The 1.19 million women who received a mammogram in 2020-2021, compared to 2.12 million last year, means almost a million women missed or postponed important breast exams.
Charities have consistently heard from women who were unable to get through to an appointment or were told there were no more appointments as open invitations were recommended in September 2020.
The move is justified by the fact that women are more likely to come to an appointment they have booked themselves, making better use of the limited capacities of the NHS and working out the backlog more quickly.
But the NHS now recommends “open invitations”, which require women to call and make their own appointment. Now a study shows the worrying impact of losing scheduled appointments, which the charity Breast Cancer Now fears could be a “key reason” for the massive drop in the number of women being screened
But the new study of more than 240,000 women in London found that only 53.1 percent of women turned up for a mammogram when there were open invitations.
This compared to 60.6 percent of women who only received scheduled appointments.
The difference, scaled down to the 1.1 million women aged 50 to 70 who came for screening in 2020-2021, suggests that around 100,000 women in England miss a mammogram each year.
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More than 700 cases of breast cancer may be missed nationwide.
These calculations assume that around two-thirds of women in England receive open invitations as in the study.
It is unclear how many women actually receive invitations across the country, as local screening units can decide how closely to follow the national recommendation.
The study’s principal investigator, Professor Stephen Duffy of the Wolfson Institute of Population Health, Queen Mary University of London, said: “The staff of the NHS breast screening program have worked tirelessly to recover from the pandemic era.
“We now have to think about how to increase the number of women who are selected rather than just being invited.
“One potential solution is to return to scheduled appointments.”
Overall, the study, published in the Journal of Medical Screening, suggests that one in 20 women who do not have a mammogram miss one because of open invitations.
It comes after Bedfordshire and Hertfordshire Breast Screening Service decided last year to switch from open invitations to timed appointments in a bid to increase mammogram uptake.
Pre-pandemic NHS policy was for all women to receive a letter with a time slot for their breast exam appointment and a second letter with a new time slot if they do not attend.
The NHS said that more women are being invited for breast screening than before the pandemic and that open appointments allow women to “make appointments at busy times”.
A spokesman said: “The NHS has also increased capacity by introducing evening and weekend sessions, along with investing more than £80m to increase capacity and staff numbers, so we strongly encourage women to extend their invitations take to apply for breast examinations the following screening unit.’
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
