Study finds UK breast-cancer screening rules miss most high-risk women under 50

Researchers say current NHS guidelines for women under 50 overlook up to 95% of those at elevated breast-cancer risk, recommending broader risk assessments.

A team from Cambridge University and the Institute of Cancer Research published a study in the British Journal of Cancer showing that NHS screening criteria for women under 50 are too narrow, missing as many as 95% of those at higher risk of breast cancer. The current NICE guidance relies solely on inherited gene markers and family history, ignoring lifestyle and reproductive factors. Using the multifactorial Boadicea calculator, researchers found that 26.5% of under-50 women would be classified as above-average risk, capturing 34.8% of cancers that develop within ten years, versus only 1.4% and 4.4% under existing rules.

Juliet Usher-Smith, the study’s lead, calls for guideline revision but notes the added workload and possible anxiety for women. Cancer Research UK’s Sowmiya Moorthie adds that any changes must be accessible and consider the emotional impact of extra referrals. NICE welcomed the findings but said current evidence does not yet justify a policy shift, and the NHS breast-cancer programme continues regular evaluation by the UK National Screening Committee.