A study to see how well a way of encouraging older women with breast cancer symptoms to go to their doctor works

Cancer type:

Breast cancer





This study looked at an intervention to increase awareness of breast cancer and promote early reporting of symptoms by older women.

All women are at risk of developing breast cancer. Older women are more at risk than younger women, but are more likely to delay going to their doctor if they notice a change to their breasts. Older women are also more likely than younger women to be diagnosed with breast cancer at a more advanced stage, making it more difficult to treat.

In an earlier study called the Promoting Early Presentation trial (PEP), researchers developed a way of

  • Increasing older women’s awareness of breast cancer risk and symptoms
  • Encouraging them to know what their breasts normally look and feel like
  • Increasing their confidence and motivation to visit their GP if they notice any changes to their breasts

This intervention involves a discussion with a radiographer Open a glossary item and a booklet to take home.

We know from the PEP trial that having this discussion helps to increase breast cancer awareness in older women in a research setting. The aim of this study was to measure the impact of the PEP intervention for older women in the NHS Breast Screening Programme when it is done by NHS staff, not by research staff.

Summary of results

The research team found that the Promoting Early Presentation (PEP) intervention did increase the awareness of older women.

The research team trained 19 NHS radiographers to deliver the PEP intervention. These radiographers then offered PEP to 830 women having mammograms, and 551 women agreed. Of these, 457 women completed questionnaires at the time of screening and a month later. The questionnaires asked them about breast cancer symptoms, risk factors and factors that might affect their decision to go and see a doctor with a serious symptom.

789 women who were having mammograms but who didn’t have the PEP intervention also filled out the questionnaires.

When the research team compared the 2 groups one month after PEP, they found that those who’d had the PEP intervention

  • Knew more symptoms
  • Were more aware that increasing age was a risk factor for breast cancer
  • Were more likely to check their own breasts for changes at least once a month
  • Were more confident that they would notice changes

The research team concluded that the PEP intervention did increase the awareness of older women going for NHS breast screening.They plan to assess the impact of the PEP intervention 1 year after having a mammogram. We will update this page once these results are available.

We have based this summary on information from the team who ran the study. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The results we quote above were provided by the trial team. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Amanda Ramirez

Supported by

Cambridge University Hospitals NHS Foundation Trust
Gateshead Health NHS Foundation Trust
King's College London
Maidstone and Tunbridge Wells NHS Trust
Medway NHS Foundation Trust
NHS Cancer Screening Programmes
National Institute for Health Research Cancer Research Network (NCRN)
Norfolk and Norwich University Hospitals NHS Foundation Trust
University Hospitals Coventry and Warwickshire

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

Oracle 8014

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Caroline took part in a clinical trial for breast cancer

“I had treatment last year and I want to give something back.”

Last reviewed:

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