Today sees a debate in Parliament that looks at lowering the breast cancer screening age to 40 years old and increasing the frequency of mammograms to once a year. In this blog, we take a look at how we can provide better screening and diagnosis for young people. 

What is breast screening? 

Breast screening uses image scans, most commonly a mammogram (a type of X-ray) or an ultrasound, to detect breast cancer before symptoms appear. The UK’s National Breast Screening Programme currently invites women aged  50 to 71  for a mammogram every  three years.

Today’s petition calls for the screening age to be lowered to 40 and for mammograms to be offered annually. 

Screening is one of the most effective tools for identifying breast cancer early. 

Why this debate matters

Breast cancer isn’t an older person’s disease. 

• More than half of all breast cancer cases in the UK occur in people outside the national screening age, 1 in 6 are in people under 50

• Outcomes for younger people are significantly worse. They’re more likely to have the most aggressive forms of the disease and are most likely to have a recurrence

• Breast cancer is the leading cause of disease-related death in women under 50 in the UK, and the third-leading cause of death overall for this group

• Health inequities are acute – the average age of diagnosis for a Black woman with breast cancer is 46 (4 years below the start of regular screening) 

• 1 in 3 younger people with breast cancer report having been initially dismissed by a healthcare professional when presenting with symptoms, as they were deemed “too young.” 

Our position

CoppaFeel! does not support a blanket lowering of the national breast cancer screening age to 40, or a move to annual mammograms as a universal offer.

We recognise the urgency, but the evidence shows us this isn’t the right solution. 

• Mammography is less effective in younger women. Younger people are more likely to have denser breast tissue, which appears similar to cancer on scans and can also hide cancer cells, making results harder to interpret and increasing the risk of both false positives and missed diagnoses. 

• More frequent scans mean more radiation exposure. Women under 50 would require more frequent scans, increasing cumulative radiation exposure in a way that, in most cases, means the risks would outweigh the benefits. 

• Capacity can’t keep pace. Expanding screening by 50% and from every 3 years to annually would be very hard to deliver in an already overstretched NHS. 

However, we strongly agree that the status quo is unacceptable. The current screening system was not built for younger people, and we cannot continue screening based on age alone. 

What we’re calling for 

1. Screen people based on risk – Not just age

We propose piloting a proactive risk assessment for people aged 18–49, taking into account: 

• Family history 

• Behavioural and environmental risk factors 

• Polygenic risk (via a simple saliva test that analyses thousands of tiny genetic variations) 

• Breast density 

Those identified as being at increased risk would be offered tailored risk-reduction advice and invited for earlier or more frequent screening. If successful, this pilot would scale into a  screening programme based on risk, replacing the current age-based model. 

This approach has strong evidence behind it, including trials in the UK and Australia that point to better identification of risk and diagnosis, as well as potential cost-saving benefits to the health system. 

People identified as higher risk must also receive wrap-around support: risk reduction guidance, psychosocial support, and help with keeping appointments. 

2. Invest in better diagnostic tools

Mammography is not always the best diagnostic tool, particularly for younger people with dense breast tissue. We want to see: 

• Investment in alternative diagnostic pathways, such as dye-enhanced mammography and MRIs, to improve accuracy for those who need them 

• Development of scalable, cheaper diagnostics that can broaden access and generate savings for reinvestment into a better system 

• Consideration of ultrasound as part of expanded diagnostic pathways, particularly for younger people where mammography has limitations 

3. Embed awareness at a system level

In the absence of a universal screening programme for younger people, awareness must become part of the system — not an afterthought. This means: 

• Including brief, structured conversations about breast awareness as part of routine health appointments — cervical screening, HPV vaccination, and NHS Health Checks. 

• Partnering with grassroots, community and faith-based organisations to deliver culturally relevant health education, particularly in communities facing the greatest inequities. 

Educating younger people about modifiable risk factors: at least 30% of breast cancers could be prevented, with physical exercise, balanced diet and alcohol control being the most significant protective factors. 

Younger people need action

The NHS 10-Year Plan commits to diagnosing 75% of cancers early by 2028 and tackling health inequities. The National Cancer Plan sets a target of 75% five-year survival for all cancers. 

Without action on breast cancer in younger people, these ambitions won’t be met.