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.