Women who miss their first breast cancer screening appointment are 40% more likely to die from the disease, according to a large Swedish study.
Researchers at the Karolinska Institute tracked about 500,000 women who received their first screening invitation between 1991 and 2020. Published in the British Medical Journal, the study followed participants for up to 25 years.
Almost one in three women (32%) did not attend their first mammogram. Those who missed it were less likely to attend later screenings, more likely to be diagnosed at an advanced stage, and had higher breast cancer mortality rates – 9.9 deaths per 1,000 women over 25 years, compared with seven per 1,000 among those screened.
While overall breast cancer rates were similar, the researchers said the increased death risk was linked to delayed detection rather than higher incidence. They concluded: “First screening non-participants had a 40% higher breast cancer mortality risk than participants, persisting over 25 years.”
A linked editorial by US researchers noted that attending a first appointment is “far more than a short-term health check,” describing it as a “long-term investment in breast health and survival.” Even if no cancer is found, the visit provides vital information about risk reduction and early warning signs.
In England, women aged 50 to 71 are invited for mammograms, with most receiving their first by age 53. NHS figures show 70% were up to date with screening as of March 2024, leaving nearly one in three behind. Claire Rowney, chief executive of Breast Cancer Now, warned that “a worryingly high number of women” miss their first appointment and called for urgent action to improve access and uptake.
The study comes alongside sobering global forecasts. Research in The Lancet projects annual cancer deaths will rise nearly 75% to 18.6 million by 2050, with new cases climbing 61% to 30.5 million, driven by ageing populations and preventable risk factors such as smoking, poor diets, and high blood sugar.
But there was some positive news: scientists reported in Nature that blocking a protein known as SPP1 could halt the spread of pancreatic ductal adenocarcinoma, the deadliest form of pancreatic cancer, and potentially extend survival. Professor Axel Behrens of the Institute of Cancer Research said the finding could pave the way for new targeted treatments.
