Reduction in women screened for breast cancer between 2020 and 2021, NHS report finds

Cancer

Last year, we reported on the potential impact of the pandemic on the number of women being screened for breast cancer.

Now, a new report by NHS Digital has revealed that there was a 44.1% decrease in the number of women, aged over 45, who were screened for breast cancer in England between April 2020 and March 2021, compared to the previous financial year.

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.

– Jodie Moffat, head of Early Diagnosis at Cancer Research UK.

Breaking down the report

Cancer screening involves testing apparently healthy people for signs that could show that a cancer is developing. Breast cancer screening aims to find cancers as early as possible, when they have the best chance of being treated successfully.

While cancer screening is a key way of improving outcomes there aren’t screening programmes for all cancers and screening won’t pick up every cancer, so it is also important to be aware of how your body usually looks and feels and to take charge and speak to your doctor if you notice anything’s that’s not normal for you.

The NHS Breast Screening Programme invites all women from the age of 50 to 70 for screening every 3 years. Breast screening is also for some trans or non-binary people.

The NHS Breast Screening Programme in England collected data on coverage, screening activity, number and uptake of invitations, as well as the outcome of screening and the rate of cancer detection of the programme.

The report, published yesterday, found that 1.19 million women aged 45 and over were screened for breast cancer between April 2020 and the end of March 2021, compared to 2.12 million in the previous year.

The report provides key information on the uptake and coverage of the screening programme. Uptake looks at how many people invited for screening took up their invite within 6 months of receiving it and coverage looks at, of those eligible for screening, how many have been adequately screened within the last 3 years.

The report highlighted that coverage, which is measured for women aged 53 to 70, dropped by around ten percentage points from 74.2% on 31 March 2020, to 64.2% on 31 March 2021.

Strikingly, the uptake of routine invitations for women, aged 50 to 70, reduced to 61.8%, the lowest since records began in 2011, down from 69.1% in the previous year.

The data from the report also showed how uptake varied across the country. Uptake of invitations was highest in the East Midlands and South East regions at 65.0% and lowest in London, with 54.1%.

Overall, around 7,000 fewer breast cancers were detected via screening in women aged 45 and over (down 39.2%) over the reporting period, compared to the year before.

How did COVID-19 impact screening?

The report is a reminder of the impact of the pandemic on cancer services. In March 2020, when the pandemic struck, breast screening in England, and in other nations of the UK, was essentially paused for approximately 3 months to protect patients and staff from the virus and to allow staff to be redeployed to respond to the COVID-19 effort.

The majority of services restarted screening for high-risk women by July that year, followed by the routine breast screening. However, due to lack of capacity, the NHS has struggled to get through the large breast screening backlog.

“Now, clarity is needed on how the extra money promised to the NHS is going to be used to tackle the chronic workforce shortages, which are holding back the recovery of cancer services and are preventing the NHS from being a world class cancer service,” says Moffat.

“However, it’s encouraging to see cancer screening services back up and running, so do keep an eye out for the invitations coming through your door.”

It will also be important to understand more about why the uptake for breast screening declined so much between 2020 and 2021 and how uptake has been affected recently. Changes in the way the breast screening programme offered appointments and concerns about COVID-19 infection may be some of the factors, but finding out more about this would be helpful, to ensure that there aren’t barriers stopping people who want to take part from attending their screening appointments.

Lilly

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