The impact of height and weight on rescreening rates within a population-based breast screening program

Introduction: Women with obesity are at increased risk of post-menopausal breast cancer and less likely to participate in breast screening. This study investigates the impact of asking women their height and weight within a population-based screening program, and the association of BMI with rescreening status. Methods: Data regarding 666,130 screening events from 318,198 women aged 50–74 attending BreastScreen Western Australia between 2016 and 2021 were used to compare crude and age-standardised rescreening rates over time. Mixed effects logistic regression was used to investigate associations of BMI with rescreening status. Results: Rescreening rates for women screened since 2016 were within 1.8% points from the previous reporting period, stratified by screening round. Increasing BMI was associated with decreased likelihood of returning to breast screening (OR = 0.993, 95% CI: 0.988–0.998; OR = 0.989, 95% CI: 0.984–0.994; OR = 0.985, 95% CI: 0.982–0.987 for women screening for the first, second and third+ time, respectively). Conclusions: This large, prospective study supports implementation of routine height and weight collection within breast screening programs. It shows that asking women their height and weight does not deter them from returning to screening and that women with increased BMI are less likely to rescreen, highlighting a need for targeted interventions to improve screening barriers for women living with obesity.