Women who skip their first breast cancer screening appointment are 40% more likely to die from the disease, according to a major new study from Sweden.
Researchers at the Karolinska Institute analysed data from about 500,000 women who received their first mammogram invitation between 1991 and 2020, with follow-up spanning up to 25 years. The findings, published in the British Medical Journal, showed that 32% of women did not attend their first screening.
Those who missed the appointment were significantly more likely to die from breast cancer – 9.9 deaths per 1,000 women over 25 years, compared with 7 deaths among those who were screened. They were also more likely to be diagnosed with advanced-stage cancers and less likely to attend future screenings.
The researchers said the higher mortality risk reflected delayed detection rather than a higher incidence of the disease. They wrote: “First screening non-participants had a 40% higher breast cancer mortality risk than participants, persisting over 25 years.”
In a linked editorial, US experts stressed that attending the first screening was about more than a single health check, calling it “a long-term investment in breast health and survival.”
In England, women are invited for breast screening between the ages of 50 and 71, with the first invitation by 53. However, NHS data shows that as of March 2024, almost one in three eligible women were not up to date with screening.
Claire Rowney, chief executive of Breast Cancer Now, described the figures as “worryingly high” and urged action to make screening more accessible and to encourage women to attend appointments.
The study comes as global cancer cases are projected to rise 61% by 2050, with deaths expected to climb nearly 75% to 18.6 million annually, according to separate research published in The Lancet.
Meanwhile, in more positive developments, scientists have identified a protein (SPP1) that could be targeted to stop the spread of pancreatic cancer, raising hopes for new drug treatments to improve survival rates.