Mind & Body · Monday, 26 October 2026
People from Black, Asian and mixed backgrounds in England are up to a third less likely to have breast cancer found by routine screening, a study of 86,564 patients finds
Black, Asian, mixed-background and poorer patients in England were up to 33% less likely to have breast cancer found by screening and up to 37% more likely to have it found in an emergency, a University of Surrey analysis of 86,564 patients finds.
86,564
adults with breast cancer whose records were studied
all diagnosed in England between 2009 and 2019
up to 33%
less likely to have the cancer found by screening
for Black, Asian, mixed-background and poorer patients, against others
up to 37%
more likely to have it found in an emergency
the same groups, in the same records
41% to 63%
of the poorest women attended, open letter against set appointment
an NHS test of invitation letters to 17,965 women in 2023
The lead story — what happened
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People from Black, Asian and mixed backgrounds in England, and people from poorer areas, were up to 33% less likely to have breast cancer found by routine screening.
[1] -
The same groups were up to 31% more likely to have it found through an urgent referral from a family doctor, and up to 37% more likely through an emergency.
[1] -
Researchers at the University of Surrey studied the records of 86,564 adults diagnosed in England between 2009 and 2019, in work paid for by the charity Breast Cancer Now.
[1] -
People with a learning disability waited 18% longer for a diagnosis, and 10% longer to start treatment.
[1] -
The NHS in England invites women aged 50 to 70 for a mammogram, a breast X-ray, every three years, to find cancers before they cause symptoms.
[2] -
About 70% of invited women in England go, against 63% across London and about 54% at the units serving Tower Hamlets, the City of London and Waltham Forest.
[2] -
Invitations are sent to the address a family doctor holds, so people who move without telling their doctor miss them, an NHS England screening lead told the London Assembly.
[3] -
In an NHS test of letters to 17,965 women in 2023, giving a set appointment time raised attendance in the poorest areas from 41.1% to 63.3%, against asking women to book.
[5] -
In focus groups with 47 Black women, fear, other demands on their time and trouble getting to appointments were among the reasons given for missing screening.
[4] -
An earlier analysis found one in three people from ethnic minority backgrounds needed three or more family doctor visits before a cancer diagnosis, against one in five overall.
[1] -
In a 2024 survey of UK adults, 93% thought routine screening is almost always good, while 51% knew some cancers grow so slowly they may never cause harm.
[6] -
Worldwide, about 2.4 million women were diagnosed with breast cancer in 2024 and 694,000 people died of it, the World Health Organization estimates.
[7]
Who is involved
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Rob Kerrison
an associate professor of cancer care at the University of Surrey; he led the study
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Breast Cancer Now
a UK breast cancer charity; it paid for the study
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The NHS Breast Screening Programme
England's free screening service; it invites women aged 50 to 70 every three years
How it unfolded
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2009-2019 86,564 people are diagnosed with breast cancer in the records the study used
[1] -
2023 An NHS test finds set appointment times raise attendance, most in poorer areas
[5] -
2024 London's screening uptake is 62.8%, below the NHS standard of 70%
[3] -
April 2025 The letter test informs how NHS England invites women
[5] -
25 Oct 2026 The Surrey analysis is reported, showing who screening misses
[1]
Where this points
The study shows who screening misses, not why; the next sign is whether uptake rises in the groups it names now that NHS England's invitations draw on the 2023 letter test.
Signals on this beat
The bar and the word are our reading of how hard each one is pushing, and the arrow is where it is heading.
Black, Asian and mixed-background patients in England were up to 37% more likely to have breast cancer found in an emergency.
Australian GP practices get a 12.5% extra payment if they charge no patient at all.
Of women with endometriosis heard by a group of UK MPs, 47% had lost income and 28% had left a job.
The Grange University Hospital in Cwmbran had more than 90 patients in its emergency department, the longest waiting about 18 hours.
The rest of the day
13 more stories on this beat.
Each with its own sources. None of these is a link to the story above.
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02
Inquest hears birthkeeper may face perjury referral
The lawyer assisting an inquest in Victoria, Australia, told the coroner on Monday that birthkeeper Emily Lal could be referred to prosecutors for perjury, which means lying under oath.
[8] Stacey Warnecke, 30, died in September 2025 after bleeding heavily following a home birth with no midwife.[8] [9] Birthkeepers have no medical training.[8] Messages on Warnecke's phone showed Lal coaching women to resist going to hospital, counsel said, against Lal's June evidence that she was only a supportive friend.[8] [22] Why it matters — Counsel told the coroner Warnecke would have survived in hospital, or at home with a registered midwife, because heavy bleeding after birth is treatable when spotted at once.
[8] Researchers say no data is collected that compares the risks of births without a midwife with home births that have one.[10] -
03
Bird flu in Utah mink, with no checks on workers
Bird flu has spread for two months at a mink fur farm about an hour from Salt Lake City, in the US state of Utah, the Guardian reported, following ProPublica.
[23] The US agriculture department told the state vet it does not regulate mink.[23] Officials reportedly did not check the farm's workers for symptoms, despite US health agency advice.[23] The owner said the state did not advise testing a worker with a red eye, a symptom the agency says to test.[23] In other countries, governments have ordered such farms to kill their mink.[23] Why it matters — An epidemiologist at Brown University said the risk to the public is low but is greatest for people near sick animals.
[23] She said other countries protect such workers with a vaccine.[23] -
04
63% of Australians now pay nothing at the GP
Almost two-thirds of Australians, 63%, now pay nothing for all their family doctor visits, up from 56% in 2024 and 2025, the Royal Australian College of General Practitioners found.
[11] Since November, practices that charge no patient at all get an extra 12.5% payment from Medicare, the public health scheme.[11] The share of GPs charging nobody rose from 12% to 26%.[11] People putting off a visit because of cost fell from 8.8% to 7.7%.[11] Why it matters — A health economist warned the survey covers about 7% of GPs and may not be typical.
[11] Medicare's own data counts visits, not people, and shows 81% of visits free in 2025-26.[11] -
05
Half of women with endometriosis lost income
An inquiry by the All-Party Parliamentary Group on Endometriosis, a group of UK MPs, found 47% of women with the condition had lost income and 28% had left a job.
[12] Endometriosis is tissue like the womb lining growing outside the womb, and it affects one in 10 women.[12] Of more than 6,000 women heard, 97% had worked in severe pain and half got no changes at work.[12] Of 250 employers surveyed, 72% gave no training on women's health.[12] Why it matters — Hayley Locksley, a school teaching assistant, had pain from age 11, was diagnosed at 24, and lost her job last October after her sick days rose.
[12] The UK government says it is working with employers.[12] -
06
Fathers file most of California's baby leave claims
Fathers filed 51% of claims for paid leave to care for a new baby in California in 2025, more than mothers for the first time.
[13] When the state scheme began in 2004, men filed about 18% of claims.[13] It pays up to eight weeks, can replace as much as 90% of a salary since 2025, and workers fund it from their own pay.[13] A Pew Research Center report found 74% of US mothers with children under 18 worked or looked for work in 2025, against 94% of fathers.[14] Why it matters — California's job agency says it cannot say why more fathers now claim.
[13] The US has no national paid leave for parents, and only 14 states and Washington DC run their own schemes.[13] -
07
A crowded Welsh hospital defends its safety
The Grange University Hospital in Cwmbran, Wales, had more than 90 patients in its emergency department during a BBC visit, with the longest wait about 18 hours.
[15] The 350-million-pound hospital opened in 2020 and has been called dangerous on social media.[15] Its bosses say its death rates are among the best in Wales once patients' illness is taken into account.[15] Ambulances were handed over within 45 minutes 67% of the time over 30 days, but 33% on the day of the visit.[15] Why it matters — Its health board, Aneurin Bevan, is still under the Welsh government's second-highest level of oversight for urgent care.
[15] Its bosses are urging seriously ill people not to be put off coming in.[15] -
08
Health board keeps paying for research it cannot value
Betsi Cadwaladr University Health Board, which runs the NHS in north Wales, is due to pay Bangor University 110,686 pounds this year for two mental health researchers.
[16] An internal NHS report in January said that by September 2025 more than 4 million pounds had been paid, with no value the board could show.[16] The deal began in 2012 as a five-year contract and was never reviewed.[16] The board has commissioned an outside review.[16] Why it matters — Llais, the Welsh health watchdog, says the concerns are not being acted on fast enough.
[16] Both the board and the university say there is no evidence of fraud.[16] -
09
WHO opens a world obesity summit in Madrid
The World Health Organization opens a three-day obesity summit in Madrid on Monday, to check progress on its 2022-2030 plan to stop obesity.
[17] It ends on 28 October with a call for countries to raise their promises for 2026 to 2030.[17] Earlier this month the WHO issued its first guidelines on obesity in children and teenagers.[18] It says 170 million people aged 5 to 19 lived with obesity in 2024, up from 2% of that age group in 1990 to 8%.[18] Why it matters — The guidelines advise against weight-loss medicines, surgery or devices for children up to age 9.
[18] For teenagers, medicines may be considered only after a supervised diet and exercise programme has failed.[18] -
10
Kidney doctors on neon-yellow urine
A doctor who advises several Trump cabinet members on diet praised having urine the colour of Mountain Dew this summer, crediting a diet of meat and fermented foods.
[19] Kidney doctors told the Guardian that B vitamins such as riboflavin can turn urine bright yellow, because the body passes out what it does not need.[19] Urine colour charts are imprecise, said a kidney doctor at the University of Washington.[19] Why it matters — Most kidney disease shows no sign: 37 million US adults have chronic kidney disease, and only one in 10 of them knows.
[19] A kidney doctor at Indiana University said a meat-only diet is not a healthy diet.[19] -
11
A map of where Parkinson's starts in the brain
A study read the active genes in 33,293 cell nuclei from the substantia nigra, the small brain area where Parkinson's disease kills dopamine-making cells.
[20] It used brains donated by Korean people with no disease, with early hidden disease and with advanced disease.[20] Clumps of a protein called alpha-synuclein built up first in one part of the area, and some kinds of dopamine cells were lost before others.[20] Why it matters — Movement symptoms of Parkinson's usually appear only after many dopamine cells are already gone, which makes it hard to find early, the authors write.
[20] Brains from East Asian donors have rarely been studied this way.[20] -
12
New muscle-loss rules flag weak surgery patients
Sarcopenia is the loss of muscle size and strength with age.
[21] Under new 2025 Asian rules for diagnosing it, a study of 779 surgery patients found about the same share had it as under the 2019 rules, roughly 23%.[21] But 43.7% of patients without it were now flagged for weak muscles.[21] They were 2.23 times as likely to leave hospital for a community hospital instead of going home.[21] Why it matters — Weak muscles of normal size marked out patients who needed more help after surgery, the authors say.
[21] They advise a version of the rules adjusted for body weight.[21] -
13
Feeds replay old war alerts as if new
Haaretz, an Israeli newspaper, set up six made-up users on Facebook, Instagram and TikTok and logged 80,000 posts over nearly four months.
[24] Among the 13,000 posts it could date, it found dozens of alarming security videos shown again weeks after they first appeared, often with no visible date.[24] One army video announcing an Iranian missile attack on 7 June kept reappearing for 90 days.[24] Each made-up user was shown about two alarming old videos a week.[24] Why it matters — A psychologist at Ben-Gurion University said such alerts put the body on high alert, and adrenaline, a stress chemical, cannot be switched off again at once.
[24] TikTok called the method flawed, and Meta, which owns Facebook and Instagram, did not answer this finding.[24] -
14
Protein shakes sold to teenagers
Protein drinks and bars are being sold to young people, and Germany's fitness protein market grew about 25% in the year to March 2025, DW reported, citing Statista.
[25] In a 2024 University of Michigan survey of nearly 1,000 parents, just under half said their 13- to 17-year-olds had used protein products in the past year.[25] The German Nutrition Society says teenagers need about 0.9 grams of protein per kilo of body weight a day, which ordinary meals can supply.[25] Why it matters — A German study from 2015 to 2017 found about half of 6- to 17-year-olds already ate more than double the protein they need.
[25] The society says there is no scientific evidence that the body needs protein supplements, even under heavy training.[25]
Why missing a check often means finding an illness in an emergency
A screening check looks for an illness before it hurts, so the people it never reaches find out only when symptoms send them to a doctor.
The twist
The women a screening programme misses still find out they have cancer. They find out later, through a doctor's referral or an emergency, because symptoms had to appear first.
The picture
How it works
- Many illnesses grow quietly before they cause pain
- A check, like a mammogram, looks for them in that quiet time
- The check only finds people it reaches: a letter, an address, a trip
- People it misses wait until symptoms send them to a doctor
- So their cancers are found later, more often in an emergency
The same force, elsewhere today
Where this chain is also running, in today's other stories.
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The birthkeeper inquest
Heavy bleeding after a birth is treatable when a trained midwife spots it at once. With nobody trained there, it was acted on only when Stacey Warnecke struggled to breathe.
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Half of women with endometriosis lost income
Hayley Locksley's pain began at 11, and doctors advised paracetamol. She was diagnosed only at 24, after years of pain.
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Bird flu in Utah mink
Officials reportedly did not check the farm's workers for symptoms. So an infection among them would come to light only once someone was ill enough to seek help.
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A map of where Parkinson's starts
Dopamine cells are lost before movement problems appear. By the time symptoms send someone to a doctor, much of the damage is done.
Where you've seen this
Car servicing
a mechanic finds a worn brake pad before the brakes fail on the road
Building inspections
a check finds a crack in a balcony before it gives way
School eye tests
a test finds a child who cannot see the board before their marks fall
The catch
Screening tends to catch slow-growing cancers, and some of them would never have caused harm. So the cancers it finds look smaller partly because of which ones it catches, not only because it found them sooner.
And the whole of it
Each person in this chain sees one step: the woman who moved and never got her letter, the clerk with the old address, the doctor reading a late scan. Most of us are on a list for some check, and we rarely know whether its letter reaches us.
What is really going on
England offers every woman aged 50 to 70 a free breast X-ray every three years, but fewer Black, Asian, mixed-background and poorer women are diagnosed through it, so more of their cancers are found in an emergency.
Why it works on us — A free service for everyone sounds fair by design, so a gap in who actually uses it stays hidden until someone counts how each person's cancer was found.
Who gains
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Australian GP practices that charge no patient
— They get an extra 12.5% payment, split between the practice and the doctor.
[11] -
Bangor University's Centre for Mental Health and Society
— It is still due 110,686 pounds from the health board this year, though a January report said the value could not be shown.
[16] -
Emily Lal
— She gave evidence only under a certificate of protection, so that evidence cannot be used against her in later proceedings.
[8] -
C&T Fenn Farms in Utah
— A fur trade representative told the state vet that killing the mink would end the business, and the farm has not culled them.
[23] -
Fathers in California
— Since 2025, paid leave for a new baby can replace up to 90% of their pay.
[13]
Who pays
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Black, Asian, mixed-background and poorer women in England
— They are up to 37% more likely to have breast cancer found in an emergency.
[1] -
People with a learning disability
— They waited 18% longer for a breast cancer diagnosis and 10% longer to start treatment.
[1] -
Women with endometriosis in the UK
— 47% lost income and 28% left a job, the MPs' inquiry found.
[12] -
Patients at the Grange hospital's emergency department
— The longest wait during the BBC's visit was about 18 hours.
[15] -
Workers near sick mink in Utah
— An epidemiologist says the risk is greatest for people exposed to sick animals, and other countries protect such workers with a vaccine.
[23] -
California workers
— They fund the state's family leave themselves, through deductions from their pay.
[13]
What nobody knows yet
Open questions from across today’s stories — ours included.
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01
Why screening finds fewer cancers in these groups.
The Surrey study measured how people were diagnosed, not why. Earlier London work points to old addresses, fear of pain and distrust, but did not measure how much each matters.
[1] [2] [3] -
02
Whether the gap is still as wide today.
The records end in 2019, and NHS England has used a test of invitation letters to guide how it invites women since April 2025.
[1] [5] -
03
How far along the cancers were when they were found.
The Surrey study counts routes to diagnosis, not size. Some cancers grow so slowly they may never cause harm, and only 51% of UK adults in a 2024 survey knew this.
[1] [6] -
04
How much of Australia's rise in free GP visits is real.
The college's survey covers about 7% of GPs, and Medicare counts visits rather than people, giving 81% where the survey gives 63%.
[11] -
05
Whether Emily Lal will be referred for perjury.
Counsel said it was open to the coroner, who will give her findings later; Lal declined to return to give more evidence.
[8] -
06
Whether any Utah mink farm worker has caught bird flu.
Officials reportedly did not check the workers for symptoms, and the US agriculture department did not answer the Guardian.
[23] -
07
Why more fathers in California now claim baby leave.
The state's job agency says it cannot say. Higher pay since 2025, more awareness, or mothers taking less leave are all possible, an advocate said.
[13] -
08
What north Wales got for more than 4 million pounds.
An internal NHS report said the board could not show value, and an outside review is still being commissioned.
[16] -
09
What countries will promise at the WHO's obesity summit.
The call for action is not due until 28 October.
[17]
Almost two-thirds of Australians, 63%, now pay nothing for all their visits to a family doctor, up from 56% a year earlier. The share putting off a visit because of cost fell from 8.8% to 7.7%.
Also true today
- In California, fathers filed 51% of claims for paid leave to care for a new baby in 2025. When the scheme began in 2004, they filed about 18%.
- At the Grange University Hospital in Wales, ambulance crews were able to hand over patients within 45 minutes 67% of the time over the last 30 days. Crews there used to wait whole 12-hour shifts to hand over a patient.
- In an NHS test of letters to 17,965 women, giving a set appointment time raised breast screening attendance in the poorest areas from 41.1% to 63.3%.
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