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Tumour characteristics were compared for screen-detected and interval cancers with breast density (Volpara) and AJCC (8th edition) prognostic stage for interval cancers. Categorical variables were compared using Pearson\u2019s \u03c7\u00b2, Fisher\u2019s exact, or binomial tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 55,010 attendees, 723 cancers were diagnosed (463 screen-detected; 260 interval). Time to interval cancer diagnosis was longer in women with dense breasts compared with non-dense breasts (median: 767 vs 624 days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Earlier stage interval cancers (\u2009&lt;\u2009IIA) were more likely diagnosed in the second and third year compared to year 1 ((33\/78) 48.7% and (56\/129) 43.4% vs (12\/53) 22.6%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Retrospectively missed interval cancers were less frequent in women with dense breasts compared with true interval cancers (41.4% vs 71.9%);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01. Retrospectively missed intervals were more likely than true intervals to be grade 3 ((15\/29) 51.7% vs (64\/196) 32.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.00), lymph node positive ((12\/29) 41.4% vs (70\/196) 35.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2265\u20090.7) and \u2265 stage IIA ((14\/29) 48.3% vs (72\/196) 36.7%, \u2265 IIA,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.68).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The time to interval cancer diagnosis was longer for women with dense breasts. Interval cancers presenting within the first year after screening had the worst prognosis. Retrospectively missed interval cancers had worse prognostic features and were more likely in non-dense breasts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>To establish the relationship between screen-detected and interval cancers and breast density, and the prognosis of interval cancers depending on time of diagnosis and radiological signs.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Interval cancers presented later in women with dense breasts, but prognostically worse cancers presented earlier and were more likely to demonstrate retrospectively visible mammographic signs.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Our finding that prognostically worse interval cancers were most likely in the first year after screening, and when radiological signs were retrospectively present, identifies an important opportunity for AI-based tools to enhance screening programmes.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12593-6","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T17:56:12Z","timestamp":1778090172000},"page":"7221-7230","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A comparison of tumour characteristics of screen-detected and interval cancers and their relationship with breast density and AJCC prognostic stage in a UK screening cohort"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4234-3824","authenticated-orcid":false,"given":"Fleur","family":"Kilburn-Toppin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Rothwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas R.","family":"Payne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Hickman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona J.","family":"Gilbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"12593_CR1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-69006-1","volume":"14","author":"NL Barclay","year":"2024","unstructured":"Barclay NL, Burn E, Delmestri A et al (2024) Trends in incidence, prevalence, and survival of breast cancer in the United Kingdom from 2000 to 2021. 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S.E.H. Radiology Artificial Intelligence Associate Editor. J.R. and F.K.-T. supported by a Future Dreams breast cancer charity grant awarded to F.J.G. F.K.-T. consulting for Genesis Care. F.J.G., recipient of the Cancer Research UK Early Detection Programme grant; consulting for Alphabet and Kheiron; honoraria for lectures from GE HealthCare; participation on an advisory board for Bayer; past president (2020\u20132022) of the European Society of Breast Imaging; current Clinical Radiology AI Lead Advisor at the Royal College of Radiologists; contrast media for unrelated trial from Bayer. Y.H. has no competing interests to declare.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"One of the authors has significant statistical expertise.","order":3,"name":"Ethics","label":"Statistics and biometry","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":4,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Institutional Review Board approval was obtained.","order":5,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Nil.","order":6,"name":"Ethics","label":"Study subjects or cohorts overlap","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"order":7,"name":"Ethics","label":"Methodology","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}}]}}