Breast cancer screening services could be facing a staffing crisis as pressure grows to bring more women into the scheme.
One in five breast imaging consultant posts advertised in the past five years took more than 12 months to fill, according to an as yet unpublished survey of 78 hospitals carried out by the Royal College of Radiologists.
Meanwhile, 38 per cent of trusts had problems finding qualified cytology staff, according to a second study by the MSF union.
It found more than 40 per cent of trusts claiming that the situation had worsened in the past year and 63 per cent predicting that it would get worse in the next 12 months.
'It cannot be right that after two years' intensive training, cytology screeners earn less than pounds7,000 and could earn more stacking shelves in supermarkets,' MSF official David Houliston told the union's annual conference last week.
'Unless something is done about staff pay, the situation will get worse.'
Stuart Field, director of the Kent breast screening service and chair of the Royal College of Radiologists' breast group, said the RCR's survey also raised concerns about morale, funding and workload (see box).
Professor Field said there was evidence that a shortage of funds was leading to slippage in the three-year recall cycle for women.
'These are very worrying findings,' he added. 'The increased number of women coming into the screening programme due to the baby boom means people are under extreme pressure.
'There is no spare capacity at the moment to start screening older women, even though this is desirable,' he said.
Breast cancer screening was introduced in 1988 for women aged 50-64.
More than a million women now take part in the programme in England and Wales, at a cost of pounds40m a year.
Robin Wilson, director of the Nottingham breast cancer screening unit, told a recent conference in London that there were 'political pressures' to extend screening to women aged up to 70.
But Roger Blanks, an epidemiologist at the Royal Marsden Hospital, said questions should be asked about whether screening techniques could be improved first.
At present, two images of the breast are taken and compared for a first screening, but most screening units use just one image on subsequent occasions. Centres also have different protocols for how many readers should look at images.
'The interesting thing is that more views and readers pick up smaller and more invasive cancers,' Dr Blanks said. 'These are the most important to treat early.
'If you just extend the programme to older women, you would pick up more cancers, but you might not pick up some of these useful ones in the younger women.'