What is your gender identity?

Male

Female

Non-binary

Trans man

Other

Prefer not to say

What is your gender identity?

Male

Female

Non-binary

Trans woman

Other

Prefer not to say

How old are you?

Is there a history of breast cancer in your close family, e.g. parent, sibling, grand-parent, child?

No

Yes

Are you postmenopausal - have your periods stopped for at least 12 months?

No

Yes

Have you ever had breast cancer?

Yes

No

Have you ever thought you may have breast cancer, for example noticed a lump, or rash, or seen your doctor about breast cancer?

Yes

No

Do you regularly check your breasts?

Yes

No

Have you ever attended a breast screen appointment (mammogram)?

Yes

No

How much alcohol do you drink?

One or more standard glasses of wine or pints of beer every day (that’s more than fourteen units a week)

A couple of standard glasses of wine or pints of beer a week (about five units a week)

Drink heavily at weekends (binge drink)

Never or only on special occasions

How much alcohol do you drink?

Less than fourteen units/week (about six pints of beer or six standard glasses of wine a week)

More than fourteen units/week (about six pints of beer or six standard glasses of wine a week)

Never or only on special occasions

How much fruit and veg do you eat a day?

I eat at least 5 fruit/veg a day

I eat less than 5 fruit/veg a day

How often do you eat processed meat (e.g. bacon, salami, sausages)?

Never or on very rare occasions

At least twice a week

At least 3 times a week

How often do you eat processed meat (e.g. bacon, salami, sausages)?

Never or on very rare occasions

At least 3 times a week

At least twice a week

How often do you eat red meat?

At least 3 times a week

Less than 3 times a week or not at all

How often do you eat red meat?

At least 3 times a week

Less than 3 times a week or not at all

Do you do at least two and a half hours a week of moderate activity, such as brisk walking or gardening?

Or at least an hour and a quarter of vigorous activity, such as running or cycling each week?

No

Less than half of that - around an hour of moderate activity or 20 mins of vigorous activity a week

Yes

Are you aware that some everyday cosmetics, cleaning and other everyday products contain chemicals that may be linked with breast cancer?

Yes

No

Do you ever check the ingredients of cosmetics, hair care or other beauty products or household items and consider what packaging is made of?

Yes

No

Do you smoke?

Yes

No, but I inhale a lot of passive, second-hand smoke

No

Do you smoke?

Yes

No, but I inhale a lot of passive, second-hand smoke

No

Do you smoke?

Yes

No, but I inhale a lot of passive, second-hand smoke

No

Are you currently using contraceptive pills, patches or implants?

No

Yes

Are you currently using, or have you ever used, Hormone Replacement Therapy (HRT)?

Yes I've been using, or have previously used, combined (oestrogen/progesterone) HRT for more than 5 years

Yes I’ve been using, or have previously used, combined (oestrogen/progesterone) HRT for less than 5 years

No, I do not use HRT

Yes, I use or have previously used oestrogen only HRT

Are you pregnant or thinking of having children?

Yes

No

Are you regularly exposed through your work, for example, as a mechanic or painter, to organic solvents, such as benzene or ethylene glycol?

Yes

No

Do you live in a city or large town?

Yes

No

Do you spend time outside in sunlight all year round?

Yes

No