Women who skip their first breast cancer screening appointment face a 40% higher risk of dying from the disease, a major Swedish study has found.
Researchers at the Karolinska Institute analysed data from around 500,000 women who were first invited to mammography between 1991 and 2020. They tracked outcomes for up to 25 years, publishing their findings in the British Medical Journal.
Almost one in three women (32%) did not attend their first appointment. Among them, breast cancer mortality was significantly higher: 9.9 deaths per 1,000 women over 25 years compared with seven per 1,000 among those who attended.
The study also found that women who skipped their first mammogram were less likely to attend later screenings and more likely to be diagnosed at advanced stages. However, overall breast cancer incidence was similar across groups, suggesting delayed detection – not higher risk of developing cancer – drove worse outcomes.
The researchers concluded: “First screening non-participants had a 40% higher breast cancer mortality risk than participants, persisting over 25 years.”
In a linked editorial, US experts said attending the first screening is “far more than a short-term health check” – it builds awareness and helps establish long-term habits for breast health.
In England, women are invited for breast screening from age 50 to 71, with the first invitation by 53. But NHS figures show 30% of eligible women were not up to date as of March 2024. Claire Rowney, chief executive of Breast Cancer Now, said urgent action was needed to encourage attendance and improve accessibility.
The study comes alongside broader warnings about cancer trends. Global cancer deaths are projected to rise nearly 75% to 18.6 million by 2050, with new cases up 61% to 30.5 million, according to The Lancet. Researchers said 42% of deaths are linked to preventable risks such as smoking, poor diet, high blood sugar and toxic exposures.
Meanwhile, new hope has emerged in pancreatic cancer research. A study published in Nature identified a protein, SPP1, that drives spread in pancreatic ductal adenocarcinoma, the most aggressive and common form of the disease. Blocking SPP1 in experiments halted metastasis and improved survival, paving the way for potential new therapies.
Prof Axel Behrens of the Institute of Cancer Research in London said the findings “could keep patients living well for longer” if targeted drugs can now be developed.
