Submitted by James Cantwell on Tue, 27/01/2026 - 14:11
A new study led by researchers at the University of Cambridge, Primary Care Unit has found fragmented pathways and inequitable access in how breast cancer risk is assessed and managed for women under 50 in England, pointing to the need for systemic change.
Published in the British Journal of Cancer, Dr Maria Valasaki, Dr Juliet-Usher Smith and colleagues have undertaken the first system-wide analysis of breast cancer risk assessment, management and screening pathways in England. While NICE (National Institute for Health and Care Excellence) guidance recommends enhanced screening and risk reducing options for women at increased risk, the study finds that access to these services is often inconsistent and shaped more by geography and socioeconomic factors than by clinical needs.
During the study, researchers conducted interviews with 29 healthcare professionals and policy stakeholders across England. Participants spanned the full breast cancer risk assessment, screening and management pathway, offering a comprehensive view of how current services operate in practice.
The findings point to six priority areas for reform including, the need for a standardised national service, improved digital and flexible risk assessment tools, clearer division of responsibilities across the pathway, sustained funding, and stronger skills in risk assessment. Participants also emphasised the importance of shifting from a reactive to a proactive approach to identify and support women at increased risk.
Despite the challenges identified, the study highlights a strong appetite and readiness for change within the healthcare system. In the interviews, participants recognised the value of reform and reported that the system is ready for change.
The authors inform that addressing these systemic issues could help reduce inequalities in care and support the development of a more effective breast cancer risk assessment pathway, ultimately improving early detection and prevention for women at higher risk.
Access the full study here: https://www.nature.com/articles/s41416-025-03329-2