Breast Test Wales (BTW) aims to reduce mortality from breast cancer, with women aged 50 to 70 invited for a mammogram every three years. Women over the age of 70 are able to self-refer into the screening programme. Breast Test Wales is divided into three geographical divisions with centres in Cardiff, Swansea, Llandudno and Wrexham. Eleven mobile units work across Wales to provide local screening to women who live some distance from a centre, visiting over 100 sites in every three-year round of screening. The service delivery model within Breast Test Wales invites participants based on their GP surgery of registration.
A total of 131, 611 people were invited to take part in breast screening in 2021/22, with 92,100 people taking up the offer. This compares to 63,854 people invited in 2020/21 and 42,826 people taking up the offer as this was the year of the pause and phased restart. The number invited is almost back at the number invited in 2018/19 (145,428), which reflects the efforts undertaken by the programme towards recovery whilst still operating under some Covid restrictions, and we know that there is always some variation in the numbers eligible each year.
Uptake of breast screening is reported as the proportion of invited participants who attended and were screened within six months of invitation making this the latest data available as of October 2022. In 2021/22, uptake across Wales was 70.0%, an increase from 67.1 in 2020/21 and meeting the 70% standard.
There is geographical variation in uptake across Wales at health board level with uptake ranging from 68.1% in Cwm Taf Morgannwg University Health Board (CTMUHB) to 72.5% in Swansea Bay University Health Board (SBUHB) (Table 1).
Table 1: Uptake (%) of breast screening by health board of residence, 2021/22
|
Health board |
Invited (n) |
Screened (n) |
Uptake (%) |
|
Aneurin Bevan UHB |
23643 |
16678 |
70.5 |
|
Betsi Cadwaladr UHB |
35558 |
24553 |
69.1 |
|
Cardiff & Vale UHB |
15520 |
10662 |
68.7 |
|
Cwm Taf Morgannwg UHB |
19290 |
13142 |
68.1 |
|
Hywel Dda UHB |
18214 |
13075 |
71.8 |
|
Powys Teaching HB |
1820 |
1257 |
69.1 |
|
Swansea Bay UHB |
17532 |
12712 |
72.5 |
|
All-Wales |
131611 |
92100 |
70.0 |
The Wales total doesn’t add up exactly as a few people cannot be assigned to a health board.
Figure 1: Uptake (%) of breast screening by local authority of residence, 2021/22
Description of Figure 1: Bar Chart showing percentage uptake of Breast screening, starting with the highest which is Carmarthenshire at 72.9% and going down to the lowest which is Anglesey at 40%.
Greater geographical variation in uptake is noted at local authority area ranging from 72.9% in Carmarthenshire to 40.0% in Anglesey (Figure 1). It should be noted that only a small number of women were invited in Anglesey in this year because of the timing of the three-year round (97 women), so this figure should be treated with caution.
Our data show that there is a social gradient in uptake, with increasing deprivation associated with reducing uptake/coverage.
The absolute difference between uptake in the most and least deprived areas is 15.3% (76.2-60.9). Compared to 2020/21 this has decreased, from a difference of 18.9% (75.3-56.4). Uptake has increased in both the most and least deprived quintiles, but by a greater amount in the most deprived groups, meaning that the inequity gap is decreasing.
Figure 2: Uptake of Breast Screening by deprivation quintile – all Wales 2021/22
Description of figure 2: Bar chart showing how breast screening uptake decreases as level of deprivation increases. Uptake in the least deprived group is 76.2% but 60.9% in the most deprived group.
The pattern of uptake decreasing with increasing deprivation is generally seen across health all boards, though the difference is less pronounced in Hywel Dda and the pattern is different in Powys (where the least deprived quintile is not shown due to small numbers).
Figure 3: Uptake of Breast Screening by deprivation quintile by health board 2021/22
Description of Figure 3: Clustered Bar chart showing the pattern of breast screening uptake by deprivation in each of the seven health boards. The overall pattern is generally that uptake decreases as deprivation increases.
Across Wales in 2021/22, uptake of breast screening was lowest in the youngest age group (50-52 years) eligible for screening at 59.5% compared to 73% in the oldest age group of 65-70. The trend for lower uptake in younger age groups is consistent with previous years and is present across health boards in Wales.
Figure 4: Uptake of Breast Screening by age group – all Wales 2021/22
Description of Figure 4: Bar chart comparing breast screening uptake by age groups showing that uptake is lowest in the youngest age group and increases as participants get older.
As well as looking by age, we can also look at uptake by type of invitation, labelled here as first or recall.
Table 2: Uptake of breast screening by type of invitation – all Wales 2021/22
|
Type of Invitation |
Invited |
Screened |
Uptake |
| First |
41,418 |
16914 |
40.8 |
|
Recall |
90,193 |
75186 |
83.4 |
This shows us that people are much more likely to attend if they have attended before, fitting with the data showing that older people are more likely to respond to an invitation.