Breast Cancer Screening: Bassetlaw

Motion made, and Question proposed, That this House do now adjourn.—(Gerald Jones.)

22:59:00

The first known descriptions of breast cancer date back to beyond 3,000 BC. Hippocrates described the progressive stages of breast cancer in 400 BC, when he outlined his theory for its cause. Although breast cancer mortality rates have been decreasing since the 1970s, approximately 11,400 women and 85 men die of breast cancer every year. That is 32 deaths from breast cancer every single day of the week. We all know someone who has been impacted by breast cancer—a mother, a sister, a granny, a daughter, a colleague or a friend. For me that was my nan, the matriarch of the family, a character, fit and healthy, who went out daily to clean other people’s houses. We lost her when I was 19 years old. She was too embarrassed to show her breast to her doctor, and explained away her lump as an injury caused by falling off a window ledge when cleaning windows. By the time she finally went to the doctor, it was too late, and she died months later. We lost her too soon. Perhaps it was also fear that kept her away; two of her sisters were also taken by breast cancer. That is such a familiar story. So many women being treated for breast cancer tell of family members—aunts, sisters, mothers, grandmothers—who have been through the same experiences. My nan was of Jewish descent. It is now known that Jewish people of Ashkenazi heritage have a one in 40 chance of carrying the BRCA gene mutation, which means a much higher chance of developing breast cancer—a one in two chance before the age of 70. For the sake of my family, I am currently having genetic screening to check that, if it was the familial cause, it has not been passed down. I urge every woman of Jewish heritage to do the same. Screening is provided free by the NHS and can be done in the home.

Medical testing of the BRCA1 gene is effective, but polygenic risk factors mean that if someone has a combination of genes, they might be more at risk of breast cancer. Does my hon. Friend think we should be rolling out polygenic risk testing so that, with a better understanding of their genes, women know how often they should have their breasts checked?

My hon. Friend makes a valuable point, and I hope that the Minister has taken heed of it.

I was diagnosed and went through the journey of early-stage breast cancer during the covid pandemic. Does my hon. Friend agree that it is important that the system understands that breast cancer can present in younger women, not just in older women?

I thank my hon. Friend for that point. I have sympathy for her experiences and hope that she is now fully recovered. Yes, we must be conscious that women of all ages could have breast cancer, and awareness must be raised so that women continue to check their breasts for it. What I do know is this: breast cancer screening and early detection save lives. The earlier that breast cancer is detected, the simpler and more effective the treatment is likely to be. Between the ages of 50 and 70, on a three-year cycle, women will get a letter in the post inviting them in for screening. A chance conversation last autumn with a local GP alerted me to his concern that the number of women attending Bassetlaw hospital for screening appointments had dropped dramatically. I asked the chief executive of our local hospital trust to investigate that, and he quickly came back with some worrying figures showing that attendance had dropped in recent times to below 50% of women invited for screening. This was either due to an appointment cancellation or a no-show on the day. NHS England data shows that prior to the coronavirus pandemic 78% of women in Bassetlaw and Doncaster were going for screening. The decline is dramatic and is not unique to Bassetlaw.

I commend the hon. Lady for bringing this debate forward. I spoke to her before the debate and her concerns are those of us all, and that is why we are here—to try to make lives better. Across England, Wales and Northern Ireland breast screening coverage remained relatively steady over time until 2019, at an average of 76%, but following covid in 2019, breast screening coverage had decreased to 65% by 2022. The covid impact on breast screening is entirely worrying, as is the fact that most trusts are not back to pre-covid screen test rates. Does the hon. Lady agree that we need a co-ordinated approach throughout the United Kingdom of Great Britain and Northern Ireland to enhance screening rates? We look forward to hearing the Minister’s response.

I thank the hon. Gentleman for his contribution and agree that it is worrying that only half of the trusts in England are meeting the national target of 70% of eligible women going for their screening, but next year we hit a milestone in that it is estimated that almost 1 million women will be invited for screening. I welcome the fact that NHS England is actively encouraging more women to book and attend their screening. Will the Minister provide more detail on that? To be honest, in Bassetlaw I cannot wait for a national operation to kick in. Last month I launched the “Bassetlaw love your boobs, get them checked” campaign, supporting local women and encouraging women to go for their breast screening. I pay tribute to the wonderful Bassetlaw women who have been active in the campaign—women such as Liz Rew and Maria Charlesworth, who found lumps in their breasts and went for their screening. Barbara Baldwin and Claire Previn joined my campaign as they have had friends taken too soon by breast cancer; I do not want anyone else to have to go through that. Lynn Dixon from Bassetlaw had breast cancer in her family and was first diagnosed at the age of 36 after finding a lump, and she has just recently found another lump and was screened. This week she is facing further treatment for breast cancer. My thoughts and love are with Lynn right now. [Hon. Members: “Hear, hear.”] Jenny Bailey is a former NHS nurse and midwife in Bassetlaw who had her breast cancer identified following routine screening. The women from Bassetlaw are amazing, using their life experiences to join the fighting spirit, encouraging their friends, family and neighbours to get screened.

I thank the hon. Lady very much for introducing this debate, because it is so important. I could not agree more that screening is incredibly important, but we also need to make sure that modern radiotherapy treatment is available for those whose breast cancer has been detected. NHS England has degraded the availability of radiotherapy treatment in many regions over the last 10 years. I understand that breast cancer patients from Bassetlaw have to travel over an hour, as they do in my area, to receive the radiotherapy that they need. What might the hon. Lady say about the Government’s new cancer plan? I hope it goes a long way to resolving the problem of getting access to radiotherapy, which is so effective.

I welcome the hon. Member’s contribution. Women in Bassetlaw have to travel all the way to Sheffield once they have been diagnosed to have treatment and radiotherapy. That is a long journey and it would be better if the cancer could be treated in Bassetlaw. I wait to hear how that can be achieved in future years, because it is so important for people to be treated close to home.

I thank my hon. Friend for introducing this debate. She has mentioned several women whom I know personally, having worked with them, and she is absolutely right that they are incredible. I particularly send my sympathy to Lynn and her family. We know that barriers to improving breast cancer screening rates include not only awareness but accessibility; it is about people living in rural areas being able to get to where treatment and screening can take place. Does my hon. Friend agree that the Government need to think not only about treatment but about the way in which people access that treatment when they are in rural areas like mine and hers?

I thank my hon. Friend for his contribution and I agree with him. In Bassetlaw, we have a single unit, but there are mobile units in rural areas that might encourage a better take-up rate. The misconception that only women can get breast cancer is far too common. Almost 400 men get breast cancer every year, including my constituent Danny Emmerson from Worksop, who found some lumps in his armpits while he was sitting watching TV. He went to his GP to get checked and was quickly diagnosed with breast cancer. I thank Danny for joining my campaign to raise awareness that men get breast cancer too. My ask today is that everyone in the Chamber, man or woman, checks themselves, and encourages their wives, partners, daughters, granddaughters, sisters and all the women in their lives to attend their breast cancer screening appointments. This debate is not the end of my campaign. On 29 June, I will be running the Race for Life in my constituency and visiting the Bassetlaw Princess Diana mammography unit to help tell the story of how easy it is for people to get their breasts screened. I welcome the fact that my hon. Friends the Members for Doncaster Central (Sally Jameson) and for Doncaster East and the Isle of Axholme (Lee Pitcher) are in their places. The data for Doncaster and Bassetlaw hospitals covers all of our constituencies. While I understand that we can presume that there are lower attendance levels by those who live in our more deprived wards, will the Minister provide advice on what more the Department can do to ensure that we can get hospital-specific data for breast cancer screening uptake?

Does my hon. Friend agree that is critical that we get data at that level, so that our Doncaster and Bassetlaw teaching hospitals NHS foundation trust can target the areas, and perhaps even the age groups, in which women’s take-up is lowest?

I agree with my hon. Friend. We have data, but we remain unsure where the lowest uptake is. I would like to go to the wards in my area where uptake is low and knock on doors to encourage women to go to their screenings, so it would helpful to have precise data from the two hospitals in the Doncaster and Bassetlaw hospitals trust. Several organisations across Bassetlaw support people with cancer, and I wish to highlight the work of Aurora in Worksop, which offers support to people during and after cancer treatment. From exercise spaces to beauty treatments, emotional support or even just a cup of tea with a friendly face and a listening ear, organisations like Aurora in our constituencies are the unsung heroes for people going through the challenge that is cancer treatment.

I congratulate my hon. Friend and neighbour on securing this important debate, and on the campaign that she is leading on women and men being screened for breast cancer early. Uptake is very low nationally, which is a problem in Doncaster East and the Isle of Axholme. Incredible work is done by organisations like Visit Bawtry. In October last year, over 70 organisations turned the town pink during Breast Cancer Awareness Month, raising £15,000 for breast cancer charities and, most importantly, amplifying the message that it is important to get early detection to save lives. Does my hon. Friend agree that efforts by grassroots organisations are vital, and that the Government must support them, as well as supporting improved screening access and public health messaging?

I thank my hon. Friend for his comments, and I agree with him. Bawtry is just across the border from my constituency, and it has a very strong community. When I go to through these towns, I see how many people come out on to the street to support one another, so I am sure that the campaign he mentions is very strong. I have come across many charities and organisations working on this issue in my constituency; they often involve people who have had breast cancer, and who want to educate other women and encourage them to be screened. They are very important to the work that we are doing. Since the beginning of breast screening checks in 1988, there has been a cut-off age of 70. My campaign includes women who are above the age threshold for being invited in for screening. My nan was over 70 when she was diagnosed with breast cancer. Why do women over 70 have to rely on memory and a phone call to get their screening appointment? All women can get breast cancer; it does not discriminate by age or background. I thank Bassetlaw women Sue Shaw and Barbara Baldwin, who are both over 70 and are now missing out. They argue that the cost of treatment for breast cancer far outweighs the costs of screening. Early prevention not only saves lives, but saves the NHS money. They are calling for the threshold to be eradicated—that is their ask and mine of the Minister. As we have heard, early diagnosis of breast cancer can save lives, and I am doing everything that I can locally to encourage women to attend their screenings when they are invited. My Bassetlaw message is: love your boobs, and get them checked.

23:15:00

I thank my hon. Friend the Member for Bassetlaw (Jo White) for bringing forward this debate on a really important topic that is close to my heart and, I know, the hearts of so many other hon. Members. It is really important to ensure that as many women as possible take up the offer of screening. They should not feel embarrassed to seek help if they feel something untoward when checking their breasts. My hon. Friend has spoken really eloquently, and has been supported by other colleagues. As she has done on other occasions, she has highlighted her family’s experience of losing a loved one due to the fear of seeking medical advice, and she is right to raise the issue of the downturn in women choosing to be screened in her constituency and, sadly, across the country. Survival rates for breast cancer can be good. If breast cancer is found early, at stage one, the five-year survival rate can be as high as 98.2%, but the five-year survival rate plummets to 26.6% when breast cancer is not found until stage four. The earlier breast cancer is caught, the earlier it can be treated, and the more likely it is that the patient will recover. Everyone is encouraged to check their breasts for lumps. There have been some excellent public health campaigns over the years from various charities explaining what to look for, be it a lump, a discharge or a dimpling of the skin on the breast. If a change is found, it is essential that no time is wasted before contacting a GP. That is why screening is an essential tool in our arsenal when trying to prevent this disease. A mammogram can identify breast cancer before it is large enough to be felt. The NHS national breast cancer screening programme invites all women aged 50 to 71 to attend a screening appointment once every three years. Mammograms can be uncomfortable, as those of us who have had them know, and many women have anxiety about having to get undressed in front of strangers, but that short discomfort could save a life. It is important that we encourage all women not to put off their scans. The NHS breast screening programme was badly affected by the pandemic, as we have heard this evening. Screening for breast cancer was paused, and when it restarted, the number of women taking up the offer did not recover to pre-pandemic levels. Even after the backlog of missed appointments had been cleared, the take-up of invitations was low, and data indicates that lots of women are still not coming forward to start their screening journey. The NHS is doing more to help to drive up engagement, and we can all do more to help, as my hon. Friend is doing. The most recent NHS data shows that breast cancer screening uptake in the area including my hon. Friend’s constituency is reported at 74.1%, with an achievable standard of 80%. That is higher than the national average of 70%, but it is short of that achievable high standard. Also, the percentage of women screened within 36 months of their previous screen is reported at 97.5%, versus the acceptable standard of 90% and the achievable standard of 99%. While more can clearly be done to increase uptake, I hope that those figures for the entire patch that includes my hon. Friend’s constituency provide some reassurance that women are coming forward to be screened. However, I absolutely take the point made by her and her colleagues that the data needs to be understood at a more granular, local level—particularly data on the women coming forward in areas of high deprivation. I will ensure that my hon. Friend has access to that information following this debate. I am pleased that the Doncaster and Bassetlaw teaching hospitals breast screening service has made significant improvements over the past year to improve attendance at appointments. I really commend my hon. Friend’s “Love your boobs” campaign, and the work that she has highlighted with local women like as Liz, Maria, Barbara, Claire and Lynn, and with men such as Danny, which makes the point that is important that men also check. The service has recently expanded availability by offering more appointments outside traditional hours. It has extended its clinic hours, and has regular Saturday appointments. The invitation method has also been changed from open appointments to timed and dated appointments, which has been shown to help increase engagement, and the service has met with the Cancer Alliance and commissioners to review ways of increasing uptake. I understand that Doncaster and Bassetlaw teaching hospitals’ breast screening service is planning to invite my hon. Friend to visit a clinic in her constituency. I hope that visit will furnish her with further information about local efforts to increase uptake, and I know she will make sure that visit happens. In February this year, the NHS launched a national breast screening awareness campaign to encourage more women to take up the offer of screening, and debates such as the one we are having tonight help raise awareness of its importance. We are not complacent: as well as increasing the uptake of routine screening, we need to make sure that the women who are most at risk are screened more frequently. The breast screening after radiotherapy dataset, or BARD, programme is working to identify and invite women who received radiotherapy involving breast tissue when aged between 10 and 35. As we have heard this evening, genetic tracing programmes are also looking at identifying carriers of genes, including BRCA, that predispose individuals to a higher risk of breast cancer. Those women are entitled to more frequent screening, and we need to ensure that they are identified and informed. The UK national screening committee is considering other changes to the breast screening programme. It is looking at whether women with denser breasts need to be screened differently, and an ongoing trial called BRAID—breast radiography to aid identification of cancers in dense breasts—is looking at breast density. The UK NSC is discussing the first findings of that trial, which I am sure hon. Members will maintain a close interest in. It will continue to review BRAID and other findings as they become available to ensure that early decisions can be made to keep the screening programme updated and dynamic. We are also investigating the age thresholds for screening. Currently, only higher-risk women are invited for screening below the age of 50. The programme stops at the 71st birthday, although women aged over 70 can choose to opt back into regular screens. A trial called AgeX is reviewing whether an additional screen three years before and three years after the existing age thresholds would increase the effectiveness of this programme and ultimately save more lives, and the EDITH research study is looking at whether artificial intelligence can be used to support the reading of mammograms. If it can, that could relieve pressure on the workforce and allow more screens to take place, as there would be increased capacity to translate the results. The Government have already invested £11 million in that trial, and we keenly await the results. More widely, the Government are committed to tackling breast cancer and ensuring that women get diagnosed and treated faster and more efficiently. That is why we will publish a national cancer plan later this year. That plan will have patients at its heart and will cover the entirety of the pathway, from referral and diagnosis to treatment and ongoing care, as well as prevention, screening, research and innovation. It will seek to improve every aspect of cancer care to improve the experience of, and outcomes for, people with cancer. Our goal is to reduce the number of lives lost to cancer over the next 10 years. I again thank my hon. Friend the Member for Bassetlaw and other hon. Members for being in the Chamber this evening, giving this House an important opportunity to shine a light on the lifesaving importance of breast screening. My hon. Friend is doing a great service in publicising her work with the NHS, and I wish her good luck with Race for Life. We all have the same goal, and together, we can improve outcomes and increase the number of women surviving breast cancer. Question put and agreed to.

23:23:00