1. Purpose of the report
This report presents findings from a local survey exploring experiences of breast screening among women living in mid and south Essex. The insight has been gathered to support service improvement, inform future communications activity and address barriers to breast screening uptake.
The findings will be used by system partners, including screening services, commissioners and communications teams, to improve patient experience and participation.
2. Survey methodology
- Survey period: 15 November to 31 December 2024
- Total responses: 608
- Method: Online survey
Responses were analysed to identify common themes, barriers, and opportunities for improving breast screening services and communications.
3. Respondent profile
3.1 Age
Most respondents were aged between 45 and 74 years, with the largest proportion aged 55–64.
3.2 Gender identity
All respondents identified as women, with a small number identifying as non-binary.
3.3 Disabilities and long-term conditions
A significant proportion of respondents reported living with one or more disabilities or long-term conditions, including:
- Physical or mobility impairments
- Sensory impairments
- Long-term conditions such as cardiovascular disease, cancer and diabetes
3.4 Financial situation
The majority of respondents reported having sufficient income to meet essential needs, with some reporting additional disposable income.
3.5 Ethnic background
Most respondents identified as White British, with smaller representations from other ethnic backgrounds.
3.6 Main language
Most respondents reported English as their main language.
4. Key findings
4.1 Awareness and participation
- Received a breast screening invitation: 543 respondents (89.5%)
- Had not received an invitation: 58 respondents (9.6%)
- Unsure: 6 respondents (1.0%)
- Previously attended breast screening: 542 respondents (89.9%)
- Had not attended previously: 61 respondents (10.1%)
This indicates a high level of awareness and engagement with the breast screening programme.
4.2 Perceived importance of breast screening
Breast screening is widely valued:
- Very important: 580 respondents (95.4%)
- Important: 20 respondents (3.3%)
- Neutral or not important: 8 respondents (1.4%)
4.3 Experience of breast screening
Respondents described their most recent screening experience as follows:
- Comfortable and reassuring: 328
- Somewhat anxious but manageable: 200
- Very anxious: 23
- Confusing or unclear: 5
- Other experiences: 57
While the majority reported positive experiences, a notable minority experienced anxiety, confusion or dissatisfaction.
4.4 Likelihood of future attendance
- Very likely to attend again: 457 respondents (78.0%)
- Fairly likely: 88 respondents (15.0%)
- Not likely or unsure: 22 respondents (3.7%)
- Not applicable: 19 respondents (3.2%)
This suggests strong intent to re-attend among most respondents.
5. Additional insights
5.1 Information and reassurance needs
- 57% of respondents said a video explaining what happens during breast screening would be helpful.
Respondents expressed a desire for clearer, more detailed information to reduce anxiety and uncertainty.
5.2 Role of primary care
Many respondents reported that breast screening or breast awareness was not discussed during recent GP or nurse appointments.
- 449 respondents indicated a preference to receive breast screening information directly from their GP practice, including via letters, leaflets or face-to-face conversations.
6. Barriers to breast screening
6.1 Pain and discomfort
Pain and discomfort during the procedure were frequently cited as deterrents.
“The resting plate was too high, and the technician did not lower it. As the breast was stretched upwards it caused considerable pain.”
“Having breast squeezed between plates is uncomfortable, but necessary.”
6.2 Fear and anxiety
Concerns about potential results, the procedure itself and waiting for outcomes were commonly reported.
“Very anxious about waiting for the results.”
6.3 Accessibility and transport
Respondents highlighted barriers including:
- Parking costs
- Distance to screening locations
- Limited public transport options
- Physical accessibility issues, particularly at mobile units
“My mobility is deteriorating due to arthritis and the most convenient location is a mobile unit with steps to access the entrance.”
6.4 Staff attitude and experience
Some respondents felt that staff were rushed, impersonal or lacked empathy, which negatively affected their experience.
“Appeared to have no empathy or compassion when intimate body parts on display.”
6.5 Cultural and religious considerations
A small number of respondents highlighted the importance of access to female staff and culturally sensitive care.
“Please offer female staff and/or a chaperone for Muslim women.”
6.6 Age eligibility and awareness
Several respondents over the age of 70 expressed frustration at no longer receiving automatic invitations and felt the age cut-off did not reflect ongoing breast cancer risk.
“There is no magic wand at 70 that means I would not get breast cancer.”
6.7 Embarrassment
The intimate nature of the procedure caused discomfort or embarrassment for some respondents.
7. Non-attendance themes
Among respondents who were eligible but had not attended screening, common themes included:
- Fear of pain or diagnosis
- Lack of awareness or understanding of eligibility
- Transport and accessibility barriers
- Time constraints and appointment availability
- Low perceived personal risk
- Negative past healthcare experiences
8. Recommendations
8.1 Service improvement
- Continue clear and consistent invitation communications
- Improve explanations of the screening process to reduce anxiety
- Promote self-referral options for women over 70
- Address accessibility issues where possible
8.2 Communications and engagement
- Develop step-by-step walkthrough videos explaining the screening process
- Highlight the benefits of early detection and positive outcomes
- Address common concerns around pain, privacy and professionalism
- Reinforce the importance of prioritising breast screening
9. Use of insight
The findings from this report will be:
- Shared with the System Cancer Stewards Group and hospital screening teams to inform service improvement
- Shared with Macmillan, who funded the project
Based on these insights:
- Walkthrough videos will be developed and integrated into the invitation process
- Content will be translated into the most commonly spoken languages across Mid and South Essex and into British Sign Language
- A local breast screening communications campaign will be developed, using social, local media and community outreach
10. Conclusion
This insight report demonstrates strong support for breast screening across mid and south Essex, alongside clear opportunities to reduce anxiety, improve accessibility and strengthen communications. By acting on these findings, partners can improve experience, increase uptake and ensure more women benefit from early detection and timely treatment.