Study links changing population to low London screening rates

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As a result, screening invitations may be sent to out-of-date addresses or to people who are overseas.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