Women who skip their first breast cancer screening appointment have a 40% higher risk of dying from the disease, according to a large Swedish study.
Researchers at the Karolinska Institute analysed data from about 500,000 women who received their first screening invitation between 1991 and 2020. The findings, published in the British Medical Journal, showed that 32% did not attend their initial mammogram. Over 25 years of follow-up, non-attendees were more likely to be diagnosed with advanced breast cancer and less likely to survive.
The study found 9.9 breast cancer deaths per 1,000 women among those who skipped their first screening, compared with seven per 1,000 in those who attended. Rates of developing breast cancer were similar across both groups, suggesting the increased mortality was due to delayed detection rather than higher incidence.
The researchers concluded that first screening attendance may serve as an early predictor of long-term cancer outcomes, highlighting the importance of encouraging participation.
In an accompanying editorial, US researchers said the first appointment should be seen as “far more than a short-term health check”, noting that even without a diagnosis, women receive valuable information about risks and symptoms.
In England, women are invited for screening between the ages of 50 and 71, with the first invitation sent before age 53. As of March 2024, 70% of eligible women were up to date with screening, meaning almost one in three were not.
Claire Rowney, chief executive of Breast Cancer Now, said the findings highlighted a “worryingly high number of women” missing their first appointment, and urged action to improve accessibility and awareness.
The study comes as global cancer deaths are forecast to rise nearly 75% by 2050, driven largely by ageing populations. However, researchers noted that 42% of cancer deaths are linked to modifiable risks such as smoking, poor diet, high blood sugar and toxin exposure.
Meanwhile, scientists have identified a protein, SPP1, that could be targeted to halt the spread of pancreatic cancer, potentially offering a new pathway for treatment.
