NHS Breast Screening

[Martin Vickers in the Chair]

[Martin Vickers in the Chair]

I beg to move,

That this House has considered e-petition 742179 relating to NHS breast screening.

It is a pleasure to serve under your chairmanship, Mr Vickers. I would like to start by thanking the petitioner, Gemma Reeves, for all the hard work she has put into starting the petition and gathering over 106,000 signatures from across the UK. The petition is titled “Lower the age for invites to regular mammograms to 40 & perform annually”, and says:

“Lower the age for when you are first called to 40 and provide funding to carry out Mammograms Annually instead of every Three Years.

Early detection is key and the prevalence of Breast Cancer in young patients is rising.

I am a Chemotherapy Nurse and working in this Clinical Setting for 8 Years and I have seen a rise in Breast Cancer in Patients under the Age of 40 increase.

Early detection is key in identifying those Aggressive forms of Breast Cancer”.

This is an issue that many people here and outside the Chamber care deeply about. Breast cancer still affects too many women, and far too many women die from it every year. I had the privilege of meeting with Gemma, who is here today. She told me about her experience of being a nurse for 15 years, eight of which have been in oncology, and about her concerns from having seen a rise in breast cancer cases in younger women, especially since covid.

Breast cancer is the most common type of cancer for women in the UK—one in seven women may get it. As Gemma wrote in her petition, “Early detection is key”, and has led to improved recovery and survival rates. Over half of breast cancer cases occur in women outside the national screening age, and one in six occur in women under 50. Men, too, get breast cancer; however, they make up approximately 1% of all cases. Currently, the NHS invites women to come to their first breast screening between the ages of 50 and 53, and this goes on until they are 71. They are invited every three years, after which a woman can choose to continue going for mammograms, but will not be automatically invited. Although everyone is at risk of breast cancer, women are at a higher risk if they are over 50, have dense breast tissue, have a family history of breast or ovarian cancer, or have particular breast conditions, for example benign breast disease.

There is a breast screening pathway for those identified as NHS-targeted very high risk. It is also important to note that NICE guidelines recommend annual mammography scans for women aged between 40 and 49 at moderate risk, as well as annual mammography or MRI surveillance for some high-risk groups.

I commend the hon. Lady for securing this debate. Unfortunately, many women are diagnosed with this cancer each year. Invasive lobular breast cancer accounts for some 15% of all breast cancer cases, yet it is routinely missed until it reaches an advanced stage. Hundreds of members of this House have backed the call for a dedicated £20 million five-year research investment into the fundamental biology of lobular cancers. Does the hon. Lady agree that the Minister—I believe she is sympathetic to this—must undertake to incorporate advanced screening technologies, such as contrast-enhanced mammography or MRI, into the NHS pathway for women with dense breast tissue or a suspected lobular profile? The Government must grasp the issue and do something now.

I thank the hon. Member for his intervention. I, too, look forward to hearing the Minister’s response on that issue.

Some 1.94 million women between the ages of 50 and 70 were screened in 2024-25, and almost 20,000 cancers were detected. Cancers were detected in nine in every 1,000 women, which is a 16% increase on the previous year. Attendance to screening reached the highest level in a decade and has been championed by charities such as Breast Cancer Now, which shares public figures, stories and personal messages.

I thank the hon. Member for securing this important debate. Does she share my concern about the difference between the numbers of first-time attendees to screening and returning attendees, at 89.1% and 63% respectively? Does she have a view on how we can increase the number attending their first screening?

Screening is key, and we have to be bolder and more inventive about how we get people along to screening. There have been many public health campaigns over the years. After a campaign, there is always a rise in attendance, but when the campaign stops, attendance falls again, so I agree that that is something that the Minister must look at.

The hon. Member for Bromley and Biggin Hill (Peter Fortune) makes a valid point. Is my hon. Friend aware that between 2020 and 2023, more than three in four women in Scotland took up their screening invitations? However, take-up is varied based on deprivation: 64.2% of women in the most deprived areas attended, compared with 82.8% in the least deprived areas. Breast cancer survival rates reflect that; women from more deprived areas in particular are more likely to die at an earlier age, because they have not been for screening and are diagnosed late. Making screening available to people in innovative ways is important, but so too is screening people in their neighbourhoods. Does my hon. Friend agree?

I fully agree with my hon. Friend. Unfortunately, that is not just the case for breast screening; bowel cancer screening is lower in areas of economic and health deprivation. We must look at how we target those populations.

It is key that we continue to increase awareness of the importance of routine health appointments and modifiable risk factors. Although screening is increasing generally, the NHS breast screening programme found that one in three women still do not take up their offer of screening. As my hon. Friend said, it is key that we continue with strategies that promote the uptake of screening in areas of lower attendance such as by running awareness campaigns, sending reminder texts and deploying mobile screening units, among other strategies. In preparing for this debate, I met Breast Cancer Now, as well as CoppaFeel!, the UK’s only youth-focused breast cancer awareness charity. They call for more screening of women who have a higher risk of breast cancer, as well as providing women identified with wraparound support.

Diagnostics are key to identifying those with breast cancer successfully, although mammography is not always the best diagnostic tool, particularly for younger women and those with dense breast tissue, so it is important to invest in other diagnostics, such as MRIs, and to consider their capacity to be scaled and expanded. Younger women tend also to have denser breasts, which mammograms are worse at analysing as the scans are harder to interpret. That can lead to women having repeated scans and extended investigations.

It is important to note that most European countries screen for breast cancer between the ages of 50 and 69, although there is some variation in age ranges and frequency, with countries such as Albania, Iceland and Sweden starting screening at 40. Although breast cancer diagnoses for women under 40 are rarer, and about 4% of breast cancer cases in the UK are in women under 40, when young women get breast cancer, they are much more likely than older women to have a family history of breast cancer and genetic mutations that are associated with increased risk.

I am proud to have Walk The Walk—one of the country’s leading breast cancer charities, which has raised a huge amount of money and awareness—in my constituency. It is pushing for mammogram testing to be extended. Does the hon. Lady agree that extending it to the under-40s and the over-70s could have a notable effect on fighting this deadly cancer?

I agree, and I look forward to hearing the Minister talk about how we can take this forward.

The UK National Screening Committee is still concerned about false positives, overdiagnosis and over-treatment. In 2012, Sir Michael Marmot chaired an independent review of breast screening, which found that the current UK screening programme prevents about 1,300 deaths from breast cancer annually. However, he also found that overdiagnosis meant that, for every death prevented by screening, about three women are treated for a cancer that they do not have. As breast cancer is less common in younger women, there is a concern that overdiagnosis would be much higher in that age group. False positive results can induce long-lasting anxiety and an unwillingness to attend future screenings. It is important that screening programmes accurately weigh up the balance between potential harms and benefits. I am sure we will hear more about that in the debate.

It is a common misconception that breast cancer is not a problem any more, but more women die from breast cancers than from other cancers. We need to do more to look after women in their 40s and women under 40. We need risk-adapted screening to better improve our chances of early detection in the most vulnerable. I look forward to hearing from other Members and the Minister.

Order. I remind Members that they should bob if they wish to contribute—as they are doing. I will not impose a time limit at this stage. If you stick to about five minutes each, we should accommodate everyone.

It is a pleasure to serve under your chairmanship, Mr Vickers. I congratulate my hon. Friend the Member for North Ayrshire and Arran (Irene Campbell) on introducing the debate, and I thank everyone who signed the petition. Behind every signature is a person, a family member or a friend, who has faced the frightening possibility that cancer may be found too late. They may even have lost somebody because it was found far too late.

In Bawtry in my constituency, local people have painted the town pink over the last few years during Breast Cancer Awareness Month. They have also taken the time to promote a simple message inspired by the movie “Legally Blonde”: bend and check. It is a powerful reminder that awareness, confidence and early action can save lives. I am really glad that Epworth may also be turning the town pink later this year under Kim Penfold, who is getting shops to join in and turn their fronts pink to raise awareness of early detection and screening.

The petition calls for routine breast screening to begin at 40 and to take place annually. That is a serious and understandable ask, but we must be guided by the evidence as well as the strength of feeling. The current NHS programme invites women to be screened every three years from the age of 50 until their 71st birthday. The independent UK National Screening Committee has advised that, on the evidence currently available, lowering the age or increasing the frequency of screening could bring harm as well as benefits, as we heard from my hon. Friend. Mammograms can be less accurate for younger women with denser breast tissue, increasing the risk of false positives and unnecessary tests and treatment. However, UK Age trial findings from a study of 160,000 women over 20 years show that annual mammograms for women in their 40s significantly reduces breast cancer deaths, saving a life for 1,000 women screened—one life, millions of memories.

I recently visited the new breast care unit at County hospital, where Michelle Ellits and Mr Sekha Marla gave me a fantastic tour. One of the things they spoke about was having separate areas as people walk into the breast care unit for those who are having treatment for breast cancer and those who are there for a mammogram, because it scares women to go to the unit if they are not confident about what they are there for. Does my hon. Friend agree that although more scans, more mammograms and better support are important, something as fundamental as building design is integral in making sure that women take up the offer to get their mammogram?

My hon. Friend makes a valid point. The environment that people first walk into makes a massive difference in how they feel about their screening. I went to one of those units with my wife only a couple of weeks ago—she had a lump in her breast—and the warm welcome that she got as we walked in was so amazing; it put her at ease and it put me at ease so I could support her, and it made the whole experience as good as it could possibly be. I am also thankful to say that she is doing very well.

Will the Minister provide an update on what the Government are doing to ensure that the people who can already go for tests go for them? No woman should wait for a screening letter if she notices a lump, a change in shape, skin changes or anything that does not feel right. Whatever their age, they should contact their GP. Early diagnosis gives people more options, more time and often the chance to see children and grandchildren grow up. That is why this petition matters, and that is why, ultimately, we need to act on it.