Decrease in women screened for breast cancer

NHS Digital has reported that 1.19m women aged 45 and over were screened for breast cancer in 2020-21, a 44.1% decrease on 2019-20 (2.12m).

For women aged 50 to 70, the number of women screened decreased by 39.1%, from 1.84m in 2019-20 to 1.12m in 2020-21.

The Breast Screening Programme, England, 2020-21 provides information on the coverage, screening activity, number and uptake of invitations, as well as the outcome of screening and the rate of cancer detection of the NHS Breast Screening Programme. Coverage, which is measured for women aged 53-70, dropped around ten percentage points to 64.2% at 31 March 2021, from 74.2% at 31 March 2020.

Coverage figures are based on the proportion of the eligible population screened within the last three years. Therefore, coverage is affected by population fluctuations and screening activity over a three-year period - so changes in coverage may not directly mirror changes in the number of invites or screens in a given year.

Uptake of routine invitations for women aged 50 to 70 was 61.8% in 2020-21 (1.08m women attended from 1.75m invitations), down from 69.1% in 2019-20 (1.79m women attended from 2.60m invitations).

The report shows that uptake was highest in the East Midlands and South East regions at 65.0% and lowest in London at 54.1%.

In 2020-21, 47,198 women aged 45 and over were referred for assessment following screening. The total proportion of women aged 45 and over that were referred for assessment rose from 3.6% in 2019-20 to 4.0% in 2020-21.

Overall, the number of women aged 45 and over with cancers detected decreased from 17,771 in 2019-20 to 10,813 in 2020-21, a decrease of 39.2%. There was, however, an increase in the rate of cancers detected, from 8.4 cases per 1,000 women screened in 2019-20 to 9.1 cases per 1,000 women screened in 2020-21.

This pattern remains consistent in the core cohort of women aged 50-70.  While the number of women screened fell, there was an increase in rate of cancers detected from 8.0 cases per 1,000 women screened in 2019-20, to 8.9 cases per 1,000 women screened in 2020-21. 

Under the NHS Breast Screening Programme, eligible women will usually receive their first routine invitation for breast cancer screening between the ages of 50 and 53 and will normally be invited every three years until they are 70.

Commenting on the figures, Jodie Moffat, head of Early Diagnosis at Cancer Research UK, said: "COVID-19 has had a devastating impact on the diagnosis and treatment of cancer. During the first year of the pandemic we saw a drop off in the number of women starting treatment for breast cancer in England, which we thought was partly linked to delays in breast cancer screening. Despite the tireless work and ongoing effort of NHS staff, the NHS has struggled to get through the breast screening backlog, because of a lack of capacity."

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