The National Health Service Breast Screening Programme (NHSBSP) was set up in 1988. Women between the ages of 50 and 70 are now routinely invited for free screening every three years. Screening is for all well women without symptoms, whether they have a family history of breast cancer or not. Women over 70 are encouraged to make their own appointments.

Some women choose not to attend for breast screening. Others attend on some occasions and not others. Women’s reasons for non-attendance vary – some don’t go because they feel they are too busy. Others are deterred by the pain or discomfort of having a mammogram. Some women choose not to go because they feel fit and healthy and do not think they are at risk of developing breast cancer. Studies suggest that a few women don’t go for screening because they are afraid of being diagnosed with breast cancer. Other research has found that some women are put off going if they’ve had a false positive result – one where something is seen on the mammogram but this turns out not to be cancer (see ‘False positive results‘). Being referred to a breast clinic for further tests after screening can be worrying and can deter women from attending in future.

A British Chinese woman, who was running a family business, said she missed several screening appointments because she was extremely busy with work. When her husband suggested there was no need to attend if she felt fit and well, she decided not to go until she was less busy. She had also been put off from attending a second time because her first mammogram had been painful. She hadn’t heard of breast screening before she was invited and said that her daughter translated the invitation letter for her. Language barriers and poor access to information about breast screening can sometimes deter some women from attending.

One woman, who found the mammogram extremely painful, chose not to go for breast screening for many years. Another, who’d had a benign (non cancer) condition when she was in her late twenties, said she was too frightened to go for screening. She noted that some cancers don’t show up on mammograms and sometimes mistakes are made with the results. She wondered if there was any point in being screened if the results couldn’t be trusted.

A few women had been diagnosed with an early form of breast cancer (Ductal Carcinoma in Situ – ‘DCIS’) through screening. They had reservations about being screened for a condition that doctors didn’t fully understand. One of these women chose not to have any more routine mammograms. She didn’t see the point of her going for breast screening again and felt that it would be like ‘looking for trouble’. She criticised the current NHS breast screening leaflet for not sufficiently spelling out the benefits and risks of breast screening and for not including a visual representation of breast cancer diagnoses and deaths in women who are screened compared with those who aren’t. Several women stressed that attending for breast screening was a personal choice and should be an informed choice.

Some women noted that, although they went for breast screening, they knew people who didn’t. One said that some of her relatives didn’t go for screening and that some women don’t attend because they are afraid of being diagnosed with breast cancer.