Evidence map›Paper›PMID 40684139›Full record

ArticleBMC public health2025

Understanding barriers to breast screening: an online survey of non-attenders as part of a service evaluation in the breast screening programme in England.

Gemma Hutton, Shuping J Li, Samantha L Quaife, Adam Brentnall, Jacqui Cookson, Jacquie Jenkins, Sue Hudson, Sharon Webb, Emma O'Sullivan, Stephen W Duffy and 2 more

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In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Gemma HuttonWolfson Institute of Population Health, Queen Mary University of London, London, UK. g.hutton@qmul.ac.uk.
Shuping J LiWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Samantha L QuaifeWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Adam BrentnallWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Jacqui CooksonPrimary Care, Community, Vaccinations & Screening Directorate, NHS England, London, UK.
Jacquie JenkinsPrimary Care, Community, Vaccinations & Screening Directorate, NHS England, London, UK.
Sue HudsonPeel & Schriek Consulting Ltd, London, UK.
Sharon WebbPrimary Care, Community, Vaccinations & Screening Directorate, NHS England, London, UK.
Emma O'SullivanPrimary Care, Community, Vaccinations & Screening Directorate, NHS England, London, UK.
Stephen W DuffyWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Judith OffmanWolfson Institute of Population Health, Queen Mary University of London, London, UK.
Jo WallerWolfson Institute of Population Health, Queen Mary University of London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly detection of breast cancer through organised mammography screening of asymptomatic individuals reduces breast cancer mortality. Breast screening is offered every three years to women aged 50 to 71 years in England. However, over a third of eligible women did not attend in 2022-2023. Understanding reasons for non-attendance is critical to ensuring the effectiveness of the breast screening programme by highlighting ways to improve access to screening.

methodsAs part of a service evaluation in the NHS Breast Screening Programme (NHSBSP), we conducted a cross-sectional survey using an online questionnaire in February 2024. Participants were non-attenders from 15 NHSBSP services in England. All women invited to breast screening who subsequently did not attend in October or November 2023 and had a valid mobile number recorded on their records received a single text message containing a link to the survey. The online survey gathered demographic and basic screening history information and assessed endorsement of common barriers to breast screening. Descriptive analysis was used to identify the most commonly endorsed barriers and chi-squared tests were used to explore demographic variation in barrier endorsement.

resultsOverall, 27,729 women were identified as not attending a screening appointment in October or November 2023. Of these, 17,221 had mobile numbers and were sent a text message inviting them to participate in the survey. In total, 1,074/17,221 (6%) participants completed the survey. The most frequently endorsed barriers to breast screening were: difficulties making a convenient appointment (30%), concern that a man may do the mammogram (28%), worry about the mammogram being painful (27%), previously experiencing pain during a mammogram (26%), having too many other things to worry about (25%) and the appointment being located too far away (23%). Endorsement of the most common barriers varied significantly by age, ethnicity, mental health status and disability but not by educational level.

conclusionsThese findings identify barriers that could be targeted to increase screening uptake including increasing appointment availability and proximity, reinforcing the message that breast screening is a female-only environment as well as developing interventions to reduce and manage pain during breast screening.

Indexed as

Breast NeoplasmsEarly Detection of CancerHealth Services AccessibilityMammographyMass ScreeningPatient Acceptance of Health CareAgedCross-Sectional StudiesEnglandFemaleHumansMiddle AgedState MedicineSurveys and QuestionnairesAcceptabilityAttendanceBarriersBreast cancerBreast ScreeningMammogramSurveyUptake

Identifiers

PMID40684139
PMCPMC12275263

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.