Amongst patients with breast cancer there is strong evidence that delays in excess of 3 months between onset of symptoms and diagnosis/treatment are associated with worse survival rates than shorter delays. The predominant risk factors for patient delays in breast cancer include lack of awareness that breast symptoms could be due to cancer and lack of awareness of personal risk.

Ideally an intervention to reduce delayed presentation of breast cancer would promote early help-seeking behaviour by patients at high risk of having cancer, but would not promote anxiety amongst people at low risk. It is important that patients should not be made unnecessarily anxious, and nor should general practitioners be overburdened with consultations with the worried well population. Based on the empirical evidence for the risk factors for patient delay and using effective behavioural change techniques, we have developed and are evaluating a psycho-educational intervention to promote early presentation of breast cancer by older women. We have focused our intervention on older women who are at greater risk of breast cancer and are also more likely to delay their presentation. The intervention is delivered by trained diagnostic radiographers at the point when the women leave the routine protection afforded by the National Health Service Breast Screening Programme and is in line with government recommended practice and complementary to the Breast Screening Programme. The ultimate aim of the intervention is to reduce the proportion of older women with breast cancer who delay their presentation, and thereby save lives.

I will outline this work and other current initiatives within the United Kingdom to promote awareness and early presentation of breast cancer and how these might inform the development of policy initiatives to improve outcomes for patients within the National Health Service.