Women’s lives are in danger from having to book their own mammograms, as evidence suggests thousands are missing out on vital breast cancer checks.
Before the pandemic, all women received mammogram appointments with a set date and time.
But the NHS now recommends ‘open invitations’, which require women to call and book their own appointment.
Now a study shows the alarming impact of losing timed appointments, which charity Breast Cancer Now fears could be a ‘key reason’ for the huge decline in women being screened.
The first major study on the change in policy, conducted by Queen Mary University of London, alongside NHS England, included almost a quarter of a million women in London.
Before the pandemic, all women received mammogram appointments with a set date and time
It found women were 14 per cent more likely to turn up for a mammogram if they had an appointment with a date and time, rather than an open invitation.
Around 12,000 women in London were estimated to have missed out on breast screening because of open invitations – in just seven months.
The study did not look at the whole country, but around 100,000 women a year could be missing mammograms in England, based on its results.
Baroness Delyth Morgan, chief executive of Breast Cancer Now, said: ‘We are very worried about the impact of open invitations on the uptake of breast screening appointments.
‘We are concerned that this change could be a key reason behind the drastic drop in uptake.
‘In 2020-21, only 62 per cent of women in England took up their breast screening invite, which is the lowest level on record.’
Professor Gareth Evans, a breast cancer screening expert from the University of Manchester, said: ‘The policy on open invitations should be changed back to recommend timed appointments for all women invited for mammograms.
‘Health psychology shows that if people are asked to turn up for an appointment at a certain time, they are more likely to be there.
‘If they have to book their own appointment, there is every chance they won’t get around to it.
‘This is why attendance rates have fallen so low.’
The 1.19 million women given mammograms in 2020-21, down from 2.12 million the previous year, means almost a million women have had vital breast checks missed or delayed.
Charities have repeatedly heard from women who have been unable to get through to make an appointment, or been told there are no appointments left, since open invitations began being recommended in September 2020.
The justification for the move was that women would be more likely to attend an appointment they had booked themselves, making better use of limited NHS capacity, and getting through the backlog faster.
But the NHS now recommends ‘open invitations’, which require women to call and book their own appointment. Now a study shows the alarming impact of losing timed appointments, which charity Breast Cancer Now fears could be a ‘key reason’ for the huge decline in women being screened
But the new study of more than 240,000 women in London found when open invitations were among those sent out, only 53.1 per cent of women turned up for a mammogram.
That compared to 60.6 per cent of women who received timed appointments only.
The difference, scaled up to the 1.1 million women aged 50 to 70 attending for screening in 2020-21, suggests around 100,000 women a year in England are missing out on mammograms.
More than 700 breast cancer cases may be missed nationwide.
These calculations assume around two-thirds of women in England receive open invitations, as in the study.
It is unclear how many women are actually sent the invitations countrywide, as local screening units can each decide how closely to follow the national recommendation.
The senior investigator on the study, Professor Stephen Duffy of the Wolfson Institute of Population Health, Queen Mary University of London, said: ‘The NHS Breast Screening Programme staff have worked tirelessly to recover from the pandemic period.
‘We now have to think how best to increase the number of women being screened, not just invited.
‘One possible solution would be a return to timed appointments.’
Overall, the study, published in the Journal of Medical Screening, suggests one in 20 women who do not have a mammogram miss out on one because of open invitations.
It comes after Bedfordshire and Hertfordshire Breast Screening Service decided last year to switch from open invitations to timed appointments to increase uptake of mammograms.
The NHS policy before the pandemic was that all women should receive a letter with a timed slot for their breast screening appointment, and a second letter with a new timed slot if they did not attend.
The NHS said more women are being invited for breast screening than before the pandemic, and open appointments allow women to ‘fit arrangements around busy schedules’.
A spokesman said: ‘The NHS has also ramped up capacity by introducing evening and weekend sessions alongside over £80million investment to boost capacity and workforce, so we strongly encourage women to take up their breast screening invite and use online services to find your nearest screening unit.’
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