Women’s lives are at risk if they have to book their own mammograms as there is evidence that thousands of vital checks for breast cancer are missing.
Before the pandemic, all women had mammogram appointments with a set date and time.
But the NHS is now recommending ‘open invitations’, where women must call and make their own appointment.
Now a study shows the alarming impact of losing timed appointments, which the charity Breast Cancer Now fears could be a ‘major reason’ for the massive drop in the number of women being screened.
The first major study of the policy change, conducted by Queen Mary University of London in conjunction with NHS England, involved nearly a quarter of a million women in London.
Before the pandemic, all women had mammogram appointments with a set date and time
It found that women were 14 percent more likely to show up for a mammogram if they had an appointment with a date and time, rather than an open invitation.
It is estimated that around 12,000 women in London have missed a breast exam due to open invitations – in just seven months.
The study didn’t look at the whole country, but based on the results, about 100,000 women a year in England could miss mammograms.
Baroness Delyth Morgan, CEO of Breast Cancer Now, said: ‘We are deeply concerned about the impact of open invitations on the acceptance of breast screening appointments.
“We are concerned that this change could be a major reason for the drastic drop in adoption.
“In 2020-21, only 62 per cent of women in England took part in breast screening invitations, the lowest level ever recorded.”
Professor Gareth Evans, an expert on breast cancer screening from the University of Manchester, said: ‘The open invitation policy should be reversed to recommend timed appointments for all women invited for mammograms.
‘Health psychology shows that if people are asked to come at a certain time for an appointment, they are more likely to attend.
‘If they have to make an appointment themselves, chances are they won’t get around to it.
‘That’s why turnout rates are so low.’
The 1.19 million women who received mammograms in 2020-2021, up from 2.12 million last year, means that nearly one million women missed or postponed important breast checks.
Charities have repeatedly heard of women who couldn’t get through to an appointment, or were told there are no more appointments, since open invites were recommended in September 2020.
The justification for the move was that women were more likely to attend an appointment they had booked themselves, making better use of the NHS’s limited capacity and getting through the backlog more quickly.
But the NHS is now recommending ‘open invitations’, where women must call and make their own appointment. Now a study shows the alarming impact of losing timed appointments, which the charity Breast Cancer Now fears could be a ‘major reason’ for the massive decline in women being screened
But the new study of more than 240,000 women in London found that only 53.1 percent of women showed up for a mammogram when there were open invites.
That compared to 60.6 percent of women who only received timed appointments.
The difference, scaled to the 1.1 million women aged 50 to 70 attending for screening in 2020-2021, suggests that around 100,000 women a year in England miss mammograms.
More than 700 breast cancer cases can be missed nationwide.
These calculations assume that about two-thirds of women in England receive open invitations, as in the study.
It’s unclear how many women actually receive the invitations nationwide, as local screening units can each decide how closely they follow the national recommendation.
The study’s senior investigator, Professor Stephen Duffy of the Wolfson Institute of Population Health, Queen Mary University of London, said: “The NHS Breast Screening Program staff have worked tirelessly to recover from the pandemic period.
“We now need to think about how best to increase the number of women who are screened, not just invited.
“One possible solution is a return to timed appointments.”
Overall, the study, published in the Journal of Medical Screening, suggests that one in 20 women who don’t have a mammogram miss one because of open invitations.
It comes after Bedfordshire and Hertfordshire Breast Screening Service decided last year to switch from open invitations to timed appointments to increase mammogram acceptance.
NHS policy before the pandemic was for all women to receive a letter with a time slot for their breast screening appointment, and a second letter with a new time slot if they did not attend.
The NHS said more women are being invited for breast screenings than before the pandemic, and that open appointments allow women to “make appointments around busy schedules”.
A spokesperson said: ‘The NHS has also increased capacity by introducing evening and weekend sessions alongside more than £80m investment to increase capacity and staff numbers, so we strongly encourage women to apply for their breast screening invitations. go and use online services to find the nearest screening unit.’