Women’s lives are being put at risk by having to book their own mammograms, as evidence suggests thousands are missing out on vital breast cancer screenings.
Before the pandemic, all women received mammogram appointments with the exact date and time.
But the NHS now recommends “open invitations”, which require women to call and book their own appointment.
A study is now showing the troubling impact of missing out on scheduled appointments, which the Breast Cancer Society now fears is a ‘major cause’ of the dramatic drop in women being screened.
The first major study on change in politics, conducted by Queen Mary University of London, along with NHS England, included nearly a quarter of a million women in London.
Before the pandemic, all women received mammogram appointments with the exact date and time
The study found that women were 14 percent more likely to have a mammogram if they had an appointment with the 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 entire country, but around 100,000 women a year may miss a mammogram in England, based on its results.
Baroness Delyth Morgan, chief executive of Breast Cancer Now, said: “We are very concerned about the impact of open invitations on breast screening appointments.
We are concerned that this change could be a major reason behind the sharp drop in turnout.
In 2020-21, only 62 per cent of women in England invited breast screening, the lowest level ever.
Professor Gareth Evans, a breast cancer screening expert from the University of Manchester, said: ‘The open invitations policy should be changed again to recommend specific appointments for all women invited for mammograms.
Health psychology shows that if people are asked to come to an appointment at a certain time, they are more likely to be there.
If they have to book their own appointment, there is a high chance they won’t get around to it.
“This is why attendance rates are so low.”
1.19 million women had mammograms in 2020-2021, down from 2.12 million the year before, meaning nearly 1 million women had missed or delayed vital breast exams.
Charities have heard time and time again from women who couldn’t make it to make an appointment, or were told there were no appointments left, since open invitations started being recommended in September 2020.
The justification for the move was that women were more likely to attend an appointment they had booked themselves, make better use of limited NHS capacity, and get past the backlog faster.
But the NHS now recommends “open invitations”, which require women to call and book their own appointment. A study is now showing the alarming impact of missing out on scheduled appointments, which the Breast Cancer Society now fears is a ‘major cause’ of the dramatic drop in women getting screened.
But the new study of more than 240,000 women in London found that when open invitations were among those sent, only 53.1 percent of women showed up for mammograms.
This is compared to 60.6 percent of women who only got scheduled appointments.
The difference, which reached 1.1 million women aged 50-70 for screening in 2020-2021, suggests that around 100,000 women a year in England miss a mammogram.
More than 700 breast cancer cases may be missed across the country.
These accounts assume that about two-thirds of women in England receive open invitations, as in the study.
It is unclear how many women have already been sent invitations across the country, as each local screening unit can decide how closely to follow national recommendations.
Lead researcher on the study, Professor Stephen Duffy of the Wolfson Institute for Population Health, Queen Mary University of London, said: ‘NHS breast screening program staff have worked tirelessly to recover from the pandemic period.
We now have to think about how best to increase the number of women being screened, not just invite them.
“One possible solution is to go back to scheduled appointments.”
Overall, the study, which was published in the Journal of Medical Examination, notes 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 decided last year to switch from open invitations to scheduled appointments to increase the demand for mammograms.
NHS policy before the pandemic was for all women to receive a letter with a specific time slot for their breast exam appointment, and a second letter with a new time slot if they did not turn up.
The NHS said more women were being invited in for breast exams than before the pandemic, and that open appointments allowed women to “fit arrangements into busy schedules”.
A spokesperson said: ‘The NHS has also boosted capacity by offering evening and weekend sessions along with investing over £80m to boost capacity and the workforce, so we strongly encourage women to take an invitation to breast screening and use the online services to find their nearest scan. You have a unit.’
(tags to translate) Daily Mail