Study examines why breast screening rates are low

Dr Judith Offman is investigating the experiences of women from different ethnic backgrounds who have felt pain during breast screening

Researchers are studying why breast screening uptake is low in north-east London, and whether the process can be made more comfortable.

Dr Judith Offman at Queen Mary University of London was awarded £400,000 by charity Breast Cancer Now to investigate the experiences of women, particularly those from different ethnic backgrounds, who have felt pain during breast screening.

Last year, breast screening units that served Tower Hamlets, the City of London and Waltham Forest had an uptake rate of about 54%. The average uptake across London is 63%, and 70% in England, according to NHS data.

The experiences of women from Somali, African and South Asian populations will inform the research.

All women aged between 50 and 70 are invited to a breast screening every three years.

Breast screening works by using a breast X-ray, called a mammogram, to detect cancers before the symptoms develop.

'Fear of pain'

Dr Offman said often, women did not attend their appointments because they feared pain they had previously experienced.

"Screening shouldn't be painful, but some women do experience a short period of pain when the mammogram is taken, or find it very uncomfortable and then decide that they don't want to go again," she said.

"Often they also tell their friends and family about it and it creates a fear of pain in women who haven't been before, so they decide to avoid going for screening.

"We want to do some work to better understand how this affects women, especially in this area [of London], which is very ethnically diverse."

She added that patients who were worried a man might be present during the procedure could be reassured that the screening was a "female-only environment".

"Mammography is still recognised as the best screening tool for picking up breast cancer," she said.

"The aim of screening is to be picking up that cancer before the patient has any symptoms."

Nasim Patel said mammogram fears were barriers to the early detection of breast cancer

Cancer Research representative Nasim Patel works in the community to understand women's concerns.

She said some ethnic minority women were nervous about attending their screening appointment and were worried it would be painful.

"Many women describe feeling anxious, embarrassed, or unsure about what will happen during screening, while others worry about the implications of a possible abnormal result," she said.

"These emotions are completely understandable, but they can become real barriers to early detection."

Breast Cancer Now estimated 1,300 deaths from breast cancer were prevented each year in the UK because of early detection and intervention following a mammogram.

Dr Tamara Soaarist, consultant radiologist at St Bartholomew's Hospital, said the screening process took seconds

Paula, 57, from north London, postponed her breast screening for six months in 2020 due to the pandemic. She was called back in with invasive lobular breast cancer.

The cancer had no symptoms but could be detected through a mammogram.

She said: "After gently examining me, the surgeon commented that the areas of cancer were barely palpable to him and that I was so lucky that I went for my mammogram.

"My mammogram probably saved my life. Had I not rebooked and just waited for the next call up, my story would be very different."

Dr Tamara Soaarist, consultant radiologist at St Bartholomew's Hospital in the City of London, said: "Everyone will experience a mammogram in a different way.

"The technician will help to support you through the procedure and they will be trying to take it at your speed.

"The compression is applied slowly to a point that a patient can tolerate, and it won't be applied to very long - just a few seconds."