Breast cancer checks missing most women under 50 who are at risk, says study
Get the Health newsletter
Daily health & science — research, biotech, public health, the studies worth knowing. Free.
- NICE breast cancer screening criteria for under-50s miss up to 95% of women at higher risk because guidelines focus only on inherited genes, not lifestyle factors such as alcohol intake or obesity
- A Cambridge University and Institute of Cancer Research study using the Boadicea risk calculator identified eight times as many under-50 women who developed breast cancer compared with current NICE criteria
- Under the Boadicea model, 26.5% of women under 50 would be categorized as above-average risk and referred for further assessment, capturing 34.8% of those who develop breast cancer within a decade — versus NICE's current 1.4% referral rate catching just 4.4%
- 73% of women under 50 who develop breast cancer within a decade have no family history of the disease — the key criterion under current NICE guidelines
- Lead researcher Dr Juliet Usher-Smith said the NHS should review the criteria but acknowledged that more referrals would add to GP workloads and could cause some women unnecessary anxiety
- NICE welcomed the findings and recognized the potential of multifactorial risk tools but said current evidence does not warrant a change to its breast cancer guidelines
Why it matters: Breast cancer is the leading cause of death in women under 50 in the UK, yet current NICE criteria refer just 1.4% for further assessment — catching only 4.4% of cases. The Boadicea model would flag 26.5% of under-50s as above-average risk, capturing 34.8% of cases that develop within a decade — but at the cost of roughly tripling NHS assessment workload.
