London’s shifting population is holding down breast screening uptake, experts have said, with the capital at 62.8 per cent in 2024, below the NHS’s acceptable 70 per cent threshold.

The London Assembly Health Committee recently heard that the capital faces distinct challenges compared with the rest of the country and that these issues must be addressed.

Josephine Ruwende, a cancer screening lead at NHS England, said frequent moves within the rented sector and the cost-of-living crisis pushing people out of London had made it difficult to reach eligible patients, which she described as “population churn”.

She said: “This is people changing addresses and then not updating their GP, this then affects the invitation process because GP details are used to identify individuals who are eligible.

“In boroughs where we have the highest population churn, we see it strongly associated with lower uptake.”

She noted that even in the wealthiest boroughs there can be high levels of movement, with around 40 per cent of residents changing address within a year.

Such areas also tend to have more people who own second homes or spend long periods abroad, making it harder for the NHS to keep contact details up to date.

As a result, screening invitations may be sent to out-of-date addresses or to people who are overseas.

Leeane Graham, advocacy lead at Black Women Rising, which supports women of colour with a cancer diagnosis, said there were cultural barriers, fear and a mistrust of the health service due to previous experience within communities.

She said: “If you’ve never been for a breast screening before, the thought of having a mammogram can be really, really terrifying.”

Helen Dickens, from Breast Cancer Now, said other reasons included a lack of understanding of breast screening, along with concerns about discomfort, trust and practical issues such as travel.

She said: “We have amazing public transport and we feel that we’ve got great accessibility, but we also know that we don’t have screening centres in every borough.

“We know that for some women that barrier of transport and access will still be a really big reason why they’re not attending screenings.”

NHS London launched its first screening campaign last year in response to the figures, aiming to increase detection at an earlier stage.

Testing period blood for signs of cervical cancer could offer an accurate, convenient screening option for women who avoid clinic appointments, researchers say.

The current NHS test involves a nurse or doctor taking cells from the cervix, yet a third of those invited do not attend.

A study of the new test, which can be done at home, used blood collected on a cotton strip attached to a standard sanitary pad.

In research involving more than 3,000 women aged 20 to 54 years, Chinese investigators compared testing period blood collected on mini-pads with samples taken by clinicians.

Results were shared via a dedicated app.

When analysed in the lab, blood testing was nearly as good at identifying people with disease as other methods, and very good at ruling out those without it.

Cervical screening appointments are offered to all women, and anyone with a cervix, every five years between ages 25 and 64 in the UK.

Screening looks for high-risk human papillomavirus, a virus that can cause cancer.

A nurse or doctor carries out the test using a speculum to access the cervix.

However, five million women are not up to date, for reasons including fear, pain and discomfort.

“Cervical screening can be difficult for some women for many reasons, like if they have had a bad previous experience, they are menopausal, they have a physical or learning disability, cultural barriers, or are a survivor of sexual violence,” said Athena Lamnisos from charity The Eve Appeal.

Younger women, those with disabilities, and people from ethnic minority communities and LGBT+ groups are more likely to miss appointments.

Researchers say using menstrual blood for HPV testing is convenient, respects privacy and reduces discomfort.

Anyone who tests positive for HPV would be sent for a colposcopy, a close examination of the cervix with a magnifying instrument to look for pre-cancerous cells.

Experts caution that period blood tests are not an immediate alternative to current screening because only women who menstruate could use them.

Some also note the study may have overestimated performance because not all participants had a biopsy to double check results.

Sophie Brooks, health information manager at Cancer Research UK, said it was encouraging to see research exploring new ways to make screening more accessible.

She said testing menstrual blood for HPV was an interesting, non-invasive approach but more research in diverse groups is needed to see how it could fit into existing programmes.

Athena Lamnisos added that it was exciting to see more acceptable ways of offering a potentially life-saving test.

“People have different barriers and concerns about screening, so being able to offer a choice of different methods could be very positive for some who are eligible for screening but don’t currently attend,” she said.

The NHS is already sending at-home test kits to women in some areas of England who have missed several screening appointments.

These DIY kits, containing a vaginal swab, will be sent out more widely at some point this year.