Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential merits of reducing the starting age for routine mammograms to 40.

Each year, over 15 million people are invited for screening by National Health Service screening programmes, with over 10 million taking up the invitation. Through our NHS screening programmes, we can reduce mortality and morbidity from cancer and other conditions in the population who appear healthy and have no symptoms, by detecting conditions at an earlier, more treatable stage.

We are guided by the independent scientific advice of the UK National Screening Committee (UK NSC) on all screening matters. It is only where there is robust evidence that an offer to screen provides more good than harm that a screening programme is recommended.

As screening programmes can also cause harms, each of the adult screening programmes has both an upper and lower age range, within which there is good scientific evidence that the benefits of screening outweigh the harms.

The NHS Breast Screening Programme does not currently offer screening to women younger than the age of 50 for breast cancer due to the lower risk of women under this age developing breast cancer, and the fact that women below 50 tend to have denser breasts tissue. The density of breast tissue reduces the ability of getting an accurate mammogram, the accepted screening test for breast cancer.

There is therefore a risk of unnecessary treatment and distress for women who do not have breast cancer, but who would be subjected to invasive and painful medical treatments and diagnostic tests.

We are in line with most European countries, most of whom screen women between the ages of 50 to 69 years old.

The UK NSC recognises that screening programmes are not static and that, over time, they may need to change to be more effective. Work is underway within the breast screening programme to investigate the possibility of routinely screening below the currently recommended age. The AgeX research trial has been looking at the effectiveness of offering some women one extra screen between the ages of 47 and 49 years old.

It is the biggest trial of its kind ever to be undertaken and will provide robust evidence about the effectiveness of screening in these age groups, including the benefit and harms. The UK NSC will review the publication of the age extension trial when it reports.