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Study in Northern Ireland has found lower attendance to breast screening in those women with chronic disabilities and self-reported poor mental health.

The Challenge

It is well-recognized that early detection and diagnosis is key to successful treatment and recovery. Therefore, all women in the UK aged between 50 and 70 years are invited to attend routine breast screening every 3 years. This has shown to reduce breast cancer deaths by 20%. However, not all women decide to attend their screening appointment. Researchers at QUB wanted to investigate the impact of disability and poor mental health on attendance to breast cancer screening in Northern Ireland.

The Approach

Breast screening records were linked to 2011 Census records within the Northern Ireland Longitudinal Study. This identified a cohort of 57 328 women who were followed through one 3-year screening cycle of the National Health Service Breast Screening Programme.

The Findings

Researchers found that 36% of women reported having at least one chronic disability, and these individuals were 7% less likely to attend their breast screening appointment compared with those with no disability. As the number of disabilities increased, women were less likely to attend.

They also found that 11% of women reported poor mental health, and these individuals were 23% less likely to attend breast screening. Although poor mental health was a strong predictor of screening attendance, it did not explain the social differences in attendance such as socioeconomic status, marital status, or area of residence.

The Impact

This is the first study of its kind in Northern Ireland and highlights a number of important issues. A vital condition of the provision of free breast screening is ensuring equal access for all eligible women across the population, regardless of individual or area characteristics. The results from this study indicate a lower attendance in those with disabilities, poor mental health and from lower socio-economic backgrounds. Therefore, a re-evaluation of the system is essential to find ways to increase attendance in these vulnerable groups of women.

Emma presented the findings of this study to the Regional Group on Promoting Informed Choice in Breast Screening which included radiographers involved in promoting the breast screening programme and Health Improvement Officers from each of the trusts.

Research Team: Emma Ross, Aideen Maguire, Michael Donnelly, Adrian Mairs, Clare Hall, Dermot O’Reilly
Database: Breast screening records from the National Breast Screening System were linked to 2011 Census records within the Northern Ireland Longitudinal Study
Project Status: Published papers available in the European Journal of Public Health and Journal of Medical Screening