Survey dates: 15 November to 31 December 2024
Total survey responses: 608
Demographics of respondents
Age: Most respondents were between 45-74 years old, with the largest group being 55-64 years old.
Gender identity: All respondents identified as women, with a small percentage identifying as non-binary.
Disabilities and long-term conditions: A considerable number of respondents reported having physical or mobility impairments, sensory impairments, or long-term conditions such as cardiovascular issues, cancer, and diabetes.
Financial situation: Most respondents had enough money for necessities, with some having a little or a lot spare for extras or leisure.
Ethnic background: Most respondents were White British, with small representations from other ethnic groups.
Main language: Most respondents spoke English as their main language.
Key stats
Those who had received a breast screening invite:
- Yes: 543 (89.5%)
- No: 58 (9.6%)
- Unsure: 6 (1.0%)
Respondents who had attended a breast screening before:
- Yes: 542 (89.9%)
- No: 61 (10.1%)
Views on the importance of breast screening:
- Very important: 580 (95.4%)
- Important: 20 (3.3%)
- Neutral: 7 (1.2%)
- Not important at all: 1 (0.2%)
- Not very Important: 0 (0.0%)
Experiences with breast screening:
- Comfortable and reassuring: 328
- Somewhat anxious but manageable: 200
- Very anxious: 23
- Confusing or unclear: 5
- Other: 57
Likelihood to attend again:
- Very likely: 457 (78.0%)
- Fairly likely: 88 (15.0%)
- Not likely: 10 (1.7%)
- Not sure: 12 (2.0%)
- Not applicable: 19 (3.2%)
Findings summary
High awareness and participation: A significant majority of respondents (89.5%) have received an invitation for breast screening, and 89.9% have attended a screening before.
Perceived importance: The importance of breast screening is highly recognised, with 95.4% considering it very important.
Positive screening experience: Most respondents had a positive experience, with 328 finding it comfortable and reassuring. However, there are still some who felt anxious or found the process confusing.
Likelihood of future attendance: A considerable proportion of respondents (78.0%) are very likely to attend future screenings, indicating a strong commitment to breast health.
Video walkthrough: 57% of respondents indicated that a video explaining what to expect during the breast screening process would be helpful
GP engagement: Many respondents indicated that their GP or nurse did not mention breast screening or breast awareness during their last appointment. There were suggestions that GPs should play a more active role in reminding patients about breast screening and addressing any concerns they may have. 449 respondents would prefer to receive information about breast screening from their GP practice through letters, leaflets, or direct communication
Overall barriers to breast screening
- Pain and discomfort: Many respondents mentioned that the procedure is painful or uncomfortable, which can deter them from attending future screenings.
“The resting plate was too high, and the technician did not lower it. As the breast was stretched upwards it caused considerable pain.”
“The machine can hurt you and is not the most comfortable screening.”
“It just hurts a bit but not for long or THAT much.”
“Having breast squeezed between plates is uncomfortable, but necessary.”
- Fear and anxiety: Concerns about potential results and the fear of finding something wrong were common reasons for avoiding screenings.
“I was very anxious due to finding a lump, but the nurse conducting the exam was helpful and put me at ease.”
“Very anxious about waiting for the results.”
“I found the whole process very impersonal and the actual X-ray painful. Disappointed by the matter-of-fact attitude of staff.”
- Accessibility issues: Difficulties with transportation, inconvenient locations, and lack of parking were frequently cited barriers.
“It is disappointing that we ladies are having to pay a parking fee for this essential service, and this might prevent some from attending.”
“My mobility is deteriorating due to arthritis and the most convenient location is to a mobile unit with steps to access the entrance. Unfortunately, that causes me pain and I can feel unsafe.”
“Had difficulty finding the mobile unit in South Woodham Ferrers and it was a long way from home. Could not have got there by public transport.”
- Staff attitude: Some respondents felt that staff were unsympathetic or rushed, which negatively impacted their experience.
“The technician was not sympathetic at all.”
“Unfriendly staff member doing the screening totally unexpected. Appeared to have no empathy or compassion when intimate body parts on display.”
“Staff were very rude and impersonal. No reassurance and made me feel like I was on a factory conveyor and like I was a piece of meat.”
- Cultural and religious beliefs: A few respondents mentioned that cultural or religious reasons prevented them from attending screenings.
“Not having the option to have a female doing the tests and staff not understanding that I want a female because of faith reasons.”
“Please offer female staff and/or chaperone for Muslim women to encourage them to attend screening mammograms and seek medical help when they feel a breast lump.”
- Lack of awareness: Some people did not know enough about the breast screening process or were unaware that they could request an appointment if they were over the age limit. Many respondents over 70 expressed frustration that they no longer receive automatic invitations for breast screening. They felt that this age cut-off is arbitrary and does not consider the ongoing risk of breast cancer in older women.
“I am 76 and there is no magic wand that waves at the age of 70 to say I would not get breast cancer. Ladies in the over-70 age group should be automatically included in regular three-yearly checks.”
- Embarrassment: The intimate nature of the procedure made some respondents feel embarrassed or uncomfortable.
“Feeling embarrassed about asking to be checked because I had a concern and male doctor being dismissive because they couldn’t detect a problem.”
There were some themes from the respondents who had been eligible but not had screening.
- Anxiety and fear – “Scared of what they might find” and “I am anxious about the pain and discomfort of the procedure.”
- Lack of awareness and information “I don’t have enough information about the screening process” and “I did not know I was eligible for screening.”
- Difficulties in accessing screening locations due to transportation issues or inconvenient locations were frequently mentioned. As well as physical disabilities or health conditions that made it challenging to attend screenings were also noted.
“I have mobility issues that make it difficult to get to the screening centre.”
- Some respondents mention that time constraints are a factor as to why they have not taken up the offer of breast screening.
“The appointment times are not convenient for me.” and “I have a busy work schedule and can’t find the time to attend.”
- Some respondents did also not perceive themselves to be at risk of breast cancer and therefore did not prioritise screening.
“ I don’t think I am at risk, so I don’t see the need for screening.”
- Negative past experiences with healthcare or screening procedures influenced their decision not to attend.
“I had a bad experience last time, so I am reluctant to go again.”
Recommendations
Actionable insights to inform service provision
- Enhance communication – Continue to provide clear and informative invitation letters to achieve high awareness and participation rates.
- Address anxiety – Implement measures to reduce anxiety, such as providing more detailed information about the screening process and offering support for those who feel anxious.
- Improve clarity – ensure that the screening process is clearly explained to avoid confusion and enhance the overall experience.
- Encourage regular attendance – reinforce the importance of regular screenings through various communication channels to maintain high attendance rates.
- Self-referral for over 70s – ensure that information about self-referral options is clearly communicated to women over 70 as they approach the age cut-off.
Insights to inform future communications
- Demonstrate the procedure:
- Step-by-Step explanation: Provide a detailed, step-by-step explanation of what happens during a breast screening. Use visuals or videos to show the process, from arrival at the clinic to the actual screening and follow-up.
- Demystify the process: Explain the purpose of each step to help reduce anxiety and make the process more transparent.
- Highlight benefits
- Early detection: emphasise that early detection of breast cancer significantly increases the chances of successful treatment and survival.
- Life-saving benefits: Share compelling statistics and real-life success stories of women whose lives were saved by early detection through regular screenings.
- Health improvement: Highlight the overall health benefits of regular screenings, including peace of mind and proactive health management.
- Address Common Concerns:
- Pain management: Reassure women that pain during screening is minimal and manageable. Provide information on what to expect and tips for reducing discomfort.
- Privacy: Emphasise the strict privacy protocols in place to protect patient confidentiality.
- Professionalism: Highlight the professionalism and expertise of the medical staff. Include testimonials from women who had positive experiences to build trust.
- Improvements and support: Address any negative past experiences by highlighting improvements in the screening process and the support available for those who need it.
- Importance of making time:
- Self-prioritisation: Encourage women to prioritise their health by being available for screenings, even when they have busy schedules. Use messaging that resonates with their role as caregivers and the importance of staying healthy for their loved ones.
- Health as a priority: Reinforce the idea that taking care of one’s health is not selfish but essential for overall well-being.
- Accessibility and convenience:
- Transportation options: Provide detailed information on transportation options to and from screening locations, including public transport routes, and parking availability.
- Flexible appointments: Highlight the availability of flexible appointment times, including evenings and weekends, to accommodate different schedules.
- Accessible locations: Ensure that screening locations are accessible to all, including those with disabilities. Provide information on the accessibility features of each location.
- Risk education: Educate women on the risk factors for breast cancer and the importance of regular screenings, regardless of their perceived risk level.
- Dangers of assuming you are not at-risk:
- Challenge assumptions: Communicate that breast cancer can affect anyone, regardless of age, family history, or lifestyle. Use data to show that regular screenings are crucial for everyone.
- Essential screenings: Emphasise that regular screenings are essential for early detection and can significantly improve outcomes. Use stories and testimonials to illustrate this point.
How this insight will be used
The insights from this survey will be shared with the System Cancer Stewards Group and hospital screening teams to inform their strategies and improve service provision.
The insights will also be shared with Macmillan, who are funding the project, to ensure they are aware of the key findings and recommendations.
Based on the insights, a series of walkthrough videos will be developed. These videos will be used as part of the invitation process to provide clear and reassuring information about the breast screening procedure.
The videos will address common concerns, highlight the benefits of early detection, and provide reassurance through testimonials and detailed explanations. They will also be translated into the most spoken languages across mid and south Essex as well as British Sign Language.
The insights will also be used to develop a local breast screening communications campaign. This campaign will aim to raise awareness, address barriers, and encourage more women to attend their screening appointments.
The campaign will utilise various communication channels, including social media, local media, and community outreach, to reach a wide audience and ensure the message is effectively communicated.
By taking these steps, we aim to improve breast screening participation rates and ensure that more women have access to this vital service.