Women who skip their first breast cancer screening appointment face a 40% higher risk of dying from the disease, according to new research.
Scientists at the Karolinska Institute in Sweden analysed data from about 500,000 women invited for screening between 1991 and 2020, tracking them for up to 25 years. Results, published in the British Medical Journal, showed that 32% did not attend their first mammogram.
Those who missed the appointment were less likely to attend future screenings, more likely to be diagnosed with advanced breast cancer, and faced a long-term mortality risk of 9.9 deaths per 1,000 women over 25 years, compared with seven per 1,000 among those who attended.
The overall breast cancer incidence rate was similar between groups, suggesting delayed detection – not higher incidence – drove the increased death risk.
Researchers concluded: “First screening non-participants had a 40% higher breast cancer mortality risk than participants, persisting over 25 years.” They added that early screening behaviour could help identify at-risk groups decades before outcomes worsen.
In a linked editorial, US experts said a first mammogram is about “far more than a short-term health check”, with attendance offering long-term benefits through information, reassurance, and awareness.
In England, women are invited for screening between ages 50 and 71, with the first invitation expected by age 53. NHS data shows 70% of eligible women were up to date as of March 2024, leaving almost one in three overdue.
Claire Rowney, chief executive of Breast Cancer Now, said the “worryingly high number” missing appointments highlighted the need for urgent action to improve access and awareness.
The study comes as wider research forecasts global cancer deaths will rise by nearly 75% to 18.6m by 2050, with new cases expected to reach 30.5m. While much of this trend is driven by population growth and ageing, 42% of deaths are linked to modifiable risks such as smoking, poor diet, and high blood sugar.
In more hopeful news, scientists have identified a protein – SPP1 – that, when blocked, may slow or prevent the spread of pancreatic ductal adenocarcinoma, the most aggressive form of pancreatic cancer. The breakthrough, published in Nature, could pave the way for new treatments.
