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Missing first screening appt raises breast cancer death risk – study
Women who miss their first mammogram face a 40 per cent higher risk of dying from breast cancer over 25 years, mainly because cancers are detected later, new research has found.
Nearly a third (32 per cent) of women invited to their first breast screening did not attend. These women were also less likely to take part in later screenings.
The findings suggest that targeting this group could cut breast cancer deaths across the population.
The researchers said: “Our study shows that first screening non-participants represent a large population at an elevated risk of dying from breast cancer decades in advance. This increased mortality is modifiable and primarily attributed to late detection.”
They added: “Targeted interventions are warranted to boost adherence to mammography screening and decrease the mortality risk for those who did not participate in the first screening.”
Swedish researchers analysed registry data from nearly half a million women invited to their first screening between 1991 and 2020, tracking them for up to 25 years.
The study measured screening attendance, breast cancer diagnoses, tumour characteristics and deaths, adjusting for social, economic, reproductive and health-related factors.
Women who skipped their first screening were more likely to be diagnosed with advanced breast cancer.
Over 25 years, their death rate was 9.9 per 1,000 women compared with 7 per 1,000 for those who attended.
Overall cancer rates were similar: 7.8 per cent for participants versus 7.6 per cent for non-participants. The higher death rate therefore reflects late detection rather than more cancers occurring.
Mammograms can detect cancer early, often before a lump can be felt, which improves treatment options and survival chances.
US researchers, writing in a linked editorial, said attending the first appointment is a long-term investment in breast health and survival.
They noted that the findings should help clinicians highlight the lasting impact on mortality when speaking with patients, while also supporting continued public funding for mammography services.
The said: “Ensuring that women are informed, supported, and empowered to participate in their first screening should be a shared goal across the healthcare system.”
The authors acknowledged some limits, including that the study was observational and so cannot prove cause and effect, and that results may not apply in countries with different healthcare systems, screening schedules or cultural attitudes to prevention.
You have until Friday to nominate your femtech company of the year.
The award is one of 10 featuring at Femtech World’s third annual awards event, which attracts entries from across the UK, EU and Europe.
The Company of the Year Award is for companies that have demonstrated exceptional leadership in tackling women’s health needs through groundbreaking products, services or platforms that are shaping the future of global femtech.
If your company is driving innovation, impact and growth in this space, this award was made for you.
About the sponsor: Femovate
The category is backed by Femovate, the global femtech incubator using design to fuel innovation across every stage of a woman’s health journey, from proactive prevention through to personalised treatment.
Femovate has invested over US$2 million in design capital, working side-by-side with founding teams to bring market-ready solutions to life.
The startups it supports have collectively raised US$120 million, launched 30 products, and secured seven FDA clearances.
Why enter?
The Femtech World Awards are free to enter.
Winners and shortlisted companies receive extensive coverage across all Femtech World platforms.
Winners will also receive a trophy and the opportunity to be featured in an interview for the publication.
Find out more about the Femtech World Award and enter here by 4pm BST on Friday 17.
Women with osteoporosis may be more likely to carry a gene linked to Alzheimer’s, according to new research.
Scientists found that APOE4, the most common genetic risk factor for Alzheimer’s, can weaken bone quality in women, even when standard scans appear normal.
The study, carried out by researchers at the Buck Institute for Research on Ageing in California, US, and UC San Francisco, suggests the gene may damage bone at a microscopic level long before any visible signs.
These changes can emerge as early as midlife and remain invisible to routine imaging tests used to assess bone strength.
The findings suggest a link between Alzheimer’s risk and skeletal health and could help pave the way for earlier detection of both conditions.
Professor Birgit Schilling, a senior author of the study, said: “What makes this finding so striking is that bone quality is being compromised at a molecular level that a standard bone scan simply will not catch.
“APOE4 is quietly disrupting the very cells responsible for keeping bone strong – and it is doing this specifically in females, which mirrors what we see with Alzheimer’s disease risk.”
Doctors have long observed that people with Alzheimer’s suffer higher rates of bone fractures, while osteoporosis in women is known to be one of the earliest predictors of the disease.
Now scientists believe they may have uncovered why.
Researchers led by Dr Charles Schurman carried out a detailed analysis of proteins in aged mouse bone and found that tissue was unusually rich in molecules linked to neurological disease, including those associated with Alzheimer’s.
In particular, long-lived bone cells known as osteocytes showed elevated levels of APOE, with levels twice as high in older female mice compared with younger or male animals.
Further experiments using genetically modified mice revealed that APOE4 had a strong and sex-specific impact on both bone and brain tissue.
The disruption at the protein level was even greater in bone than in the brain.
However, the bone structure itself appeared completely normal under scans.
Instead, the gene interfered with a key maintenance process inside bone cells, preventing them from repairing microscopic channels that keep bones strong and resilient.
When this process breaks down, bones become more fragile even if they look healthy on standard imaging.
These results suggest bone cells could potentially act as early biological warning signs of cognitive decline in women carrying APOE4.
Professor Lisa Ellerby, another senior author, said: “We think targeting these cells may open a new front in preserving bone quality in this population.”
Experts say the findings highlight the need to view the body as an interconnected system rather than treating diseases in isolation.
Dementia, of which Alzheimer’s is the most common form, remains one of the UK’s biggest health challenges.
Around 900,000 people are currently living with the condition, a figure expected to rise to 1.6 million by 2040.
It is already the leading cause of death, responsible for more than 74,000 deaths each year.
Health secretary Wes Streeting has relaunched England’s women’s health strategy, vowing to stop women being “gaslit” by doctors.
Speaking before publication of the renewed strategy, the health secretary said the NHS was “failing women” and set out measures to help them access the healthcare they need.
The government said the strategy would include a new standard of care to ensure women were offered pain relief for invasive procedures, such as fitting a contraceptive coil and hysteroscopies.
Feedback would be directly linked to provider funding through a new trial, giving women more power to affect change if they have a poor experience.
Action would also be taken to ensure women no longer face long waits for diagnoses for conditions such as endometriosis, which can take a decade to diagnose.
Streeting said: “[Women] have for so long been let down by a healthcare system that too often gaslights women, treating their pain as an inconvenience and their symptoms as an overreaction.
“Whether it’s being passed from one appointment to another for conditions like endometriosis and fibroids, or a lack of proper pain relief during invasive procedures, through to having to navigate symptoms for years before receiving a diagnosis, it’s clear the system is failing women.
“Women’s voices must be central to delivering effective, respectful and empathetic care. We need to hit medical misogyny where it hurts – the wallet.
“Today’s renewed strategy will tackle the issues women face every day and ensure no woman is left fighting to be heard.”
A report last month by the women and equalities committee found that gynaecological and menstrual health had not been “sufficiently prioritised” by the government.
MPs said parts of the 10-year women’s health strategy, launched in 2022 by the Conservatives, were at risk of being scaled back or discontinued under wider changes to the NHS.
These included initiatives that had reduced waiting lists and improved women’s access to healthcare, such as women’s health hubs.
Sarah Owen, chair of the committee and a Labour MP, said: “This would be a disaster for girls’ and women’s menstrual healthcare, when it is in dire need of more support.
“It is a national scandal that nearly half a million women are on hospital gynaecology waiting lists when there are effective treatments that could be administered in primary and community care, if only they could access them.”
The report said women faced “medical misogyny” and were left to “suck it up” and suffer in pain for years because of a lack of awareness of women’s health conditions.
A redesign of clinical pathways for some women’s health issues will aim to speed up diagnosis and treatment, and there will be a review of support for families who experience repeated baby loss.
The government also promised a “single referral point” to ensure women were directed to the right place the first time they sought help.
Dr Sue Mann, NHS England’s women’s health director, said too many women were dismissed for “serious symptoms” that affected every part of their lives.
“The renewed women’s health strategy will build significantly on the work the NHS has been doing to ensure women are heard and get the specialist care they need,” she said.
Women’s health groups cautiously welcomed the renewed strategy. Emma Cox, chief executive of Endometriosis UK, said decisive action would be vital to improve women’s healthcare in England.
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