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1.19m women aged 45 and over were screened for breast cancer in 2020-21, a 44.1% decrease on 2019-20 (2.12m)¹.

For women aged 50 to 70, the number of women screened decreased by 39.1%, from 1.84m in 2019-20 to 1.12m in 2020-21².

The Breast Screening Programme, England, 2020-21 provides information on the coverage, screening activity, number and uptake of invitations, as well as the outcome of screening and the rate of cancer detection of the NHS Breast Screening Programme³.

Coverage

Coverage⁴, which is measured for women aged 53-70, dropped around ten percentage points to 64.2% at 31 March 2021, from 74.2% at 31 March 2020.

Coverage figures are based on the proportion of the eligible population screened within the last three years.

Therefore, coverage is affected by population fluctuations and screening activity over a three-year period - so changes in coverage may not directly mirror changes in the number of invites or screens in a given year.

Uptake

Uptake⁵ of routine invitations for women aged 50 to 70 was 61.8% in 2020-21 (1.08m⁶ women attended from 1.75m invitations), down from 69.1% in 2019-20 (1.79m women attended from 2.60m invitations).

The report shows that uptake was highest in the East Midlands and South East regions at 65.0% and lowest in London at 54.1%⁷.

Outcomes

In 2020-21, 47,198 women aged 45 and over were referred for assessment following screening. The total proportion of women aged 45 and over that were referred for assessment⁸ rose from 3.6% in 2019-20 to 4.0% in 2020-21.

Cancer detection

Overall, the number of women aged 45 and over with cancers detected decreased from 17,771 in 2019-20 to 10,813 in 2020-21, a decrease of 39.2%. 

There was, however, an increase in the rate of cancers detected, from 8.4 cases per 1,000 women screened in 2019-20 to 9.1 cases per 1,000 women screened in 2020-21.

This pattern remains consistent in the core cohort of women aged 50-70.  While the number of women screened fell, there was an increase in rate of cancers detected from 8.0 cases per 1,000 women screened in 2019-20, to 8.9 cases per 1,000 women screened in 2020-21. 

Under the NHS Breast Screening Programme, eligible⁹ women will usually receive their first routine invitation for breast cancer screening between the ages of 50 and 53 and will normally be invited every three years until they are 70.

Read the full report

Breast Screening Programme, England, 2020-21

Notes for Editors

1. In March 2020, all 78 NHS Breast Screening Providers (BSPs) made their own decision to pause screening for approximately 3 months (March-June 2020) to allow staff to be redeployed to respond to COVID-19, and to protect patients and staff from the virus.  The majority of services continued with or restarted screening very high-risk women by mid-April 2020 and all BSPs recommenced screening activity between April and September 2020 with the majority restarted by July 2020.  For more information on the impact of the coronavirus pandemic on the NHS Breast Screening Programme, please see Covid impact section of the report here.
2. The age extension trial (AgeX) looked at the risks and benefits of offering an extra screen to women aged 47-49 and 71-73 (just below and above the routine screening age of 50-70). The trial stopped recruitment during the pandemic, which means fewer women in those age groups will have been screened compared to 2019-20.
3. The NHS Breast Screening Programme is offered to women aged 50 to their 71st birthday.  Eligible women receive a letter explaining the programme and the benefits and risks of breast screening.  Women do not always receive an invitation when they turn 50 but can expect an invitation within three years of their 50^th birthday. 
4. Coverage is defined as the percentage of women in the population who are eligible for screening at a particular point in time (31 March 2019 in this instance), who have had a test with a recorded result within the last three years. Currently, coverage is best assessed using the 53-70 age group as women may be first called at any time between their 50th and 53rd birthdays.
5. Uptake is the percentage of women invited for screening in the year, who were screened adequately within six months of invitation.  Refers only to women who have received a routine invite to screening, it does not include short term recalls or GP and self-referrals.
6. The 1.08m uptake figure is lower than the 1.19m headline figure due to the differences in cohorts measured.  The 1.19m includes all women screened under the programme: aged 45 and over, from all routes including invites, GP-referral and self-referral as well as short-term recalls.  The 1.08m is limited to the core cohort of women aged 50 to less than 71 and through invite only.
7. The seven reporting regions are;

• North East, Yorkshire & the Humber (NEYH), made up of North East and Yorkshire & the Humber
• North West,
• East Midlands,
• West Midlands,
• East of England,
• London,
• South, made up of South East and South West

8. Referred for assessment includes women referred for cytology, core biopsy or open biopsy.
9. A woman is eligible if she has not had a double mastectomy.