Women who skip their first breast cancer screening appointment are at a 40% higher risk of dying from the disease, according to a major study of half a million women in Sweden.
Researchers at the Karolinska Institute tracked women invited to their first mammogram between 1991 and 2020, monitoring them for up to 25 years. Results, published in the British Medical Journal, showed that 32% did not attend their initial screening. These women were more likely to be diagnosed with advanced-stage breast cancer and less likely to attend future screenings.
Over 25 years, breast cancer mortality was 9.9 deaths per 1,000 women among those who missed their first appointment, compared with seven deaths per 1,000 among attendees. However, overall cancer incidence was similar in both groups, suggesting delayed detection – not higher disease rates – was the cause.
The authors wrote: “First screening non-participants had a 40% higher breast cancer mortality risk than participants, persisting over 25 years.” They argued that early attendance behaviour could help identify populations at higher risk decades before outcomes worsen.
In a linked editorial, US researchers described the first mammogram as “far more than a short-term health check”, emphasising that even without a diagnosis, the appointment provides vital information and awareness that can have lasting benefits.
In England, women are invited for screening between ages 50 and 71, with all first invitations issued by 53. As of March 2024, NHS figures show only 70% of eligible women were up to date with screening.
Claire Rowney, chief executive of Breast Cancer Now, called the missed appointments “worryingly high” and urged action to make screening easier and more accessible.
The findings come amid a global rise in cancer rates. A Lancet study projects annual cancer deaths will increase by nearly 75% to 18.6 million by 2050, driven by ageing populations and lifestyle risks such as smoking, poor diets, and high blood sugar.
In separate research offering hope, scientists at London’s Institute of Cancer Research identified a protein, SPP1, that when blocked, may stop the spread of pancreatic cancer and extend survival. Work is now underway to develop a drug targeting this protein.
