Missing a first breast cancer screening exam can be hazardous to your health. A new study in BMJ found that women who missed their first mammography screening had a 40% higher long-term risk of breast cancer death.
Mammography screening has been shown to prevent breast cancer deaths by detecting cancer earlier, when it can be treated more effectively.
- But breast screening adherence rates still aren’t as high as they should be, leaving women’s health advocates to wonder what they can do to spur better compliance.
In the new study, researchers investigated whether mammography compliance itself could be an early warning sign that women might not be taking screening seriously enough.
- They analyzed data on 433k women invited to the Swedish Mammography Screening Programme from 1991 to 2020 and correlated clinical outcomes over 25 years with whether or not patients completed their first screening exam (32% didn’t).
Compared to women who missed their first mammography appointment, women who followed through with their exam…
- Had a 40% lower risk of dying from breast cancer.
- Had lower breast cancer mortality rates per 1k women (7 vs. 9.9).
- Got nearly twice as many breast screenings over the study period (8.7 vs. 4.8 screenings).
- Had similar breast cancer incidence rates (7.8% vs. 7.6%), a sign that non-participation delayed detection rather than increased incidence.
What’s more, women who missed their first appointment were 32% more likely to have invasive cancer and had higher odds ratios for stage III and stage IV disease (OR = 1.53 and 3.61, respectively).
Researchers concluded that women who missed their first mammography appointment were also more likely to miss future ones – putting them at higher risk of breast cancer death.
- But a missed initial appointment also could serve as a warning to women’s health centers that these patients deserve extra attention, through tools as simple as more provider outreach or automatically scheduled second appointments.
The Takeaway
The new findings offer – yet again – more support for the effectiveness of population-based breast screening in reducing breast cancer deaths. What’s novel is that they show that non-participation is an early warning sign that could activate a slate of more aggressive outreach measures to bring these women in.
