Breast cancer is the most commonly diagnosed cancer in Aboriginal and Torres Strait Islander women.1,2,3 About one in 11 Aboriginal and Torres Strait Islander women will develop the disease in their lifetimes in 11 Aboriginal and Torres Strait Islander women will develop the disease.2
The proportion of women screened through BreastScreen Australia is a key performance indicator for the national breast screening program. BreastScreen Australia’s National Accreditation Standards (NAS) aims for 70% or more of women in the target age range to participate in national breast screening program.1,4
About this measure
Between 2012 and 2016, there were 904 new cases of breast cancer for Aboriginal and Torres Strait Islander females.3 In the period 2012–2016, the incidence of breast cancer for Aboriginal and Torres Strait Islander females was 107.9 new cases per 100,000 females.3
In 2015–2019 the mortality rate from breast cancer for Aboriginal and Torres Strait Islander females aged 50-74, was 41.3 deaths per 100,000 women.1
The rate of breast cancer mortality in Aboriginal and Torres Strait Islander females is higher compared to the other females within the Australian community (see NCCI website). This may reflect: their more advanced tumours at diagnosis; socioeconomic disadvantage; living in remote geographical locations; and having lower participation rates in screening programs.1,2
Breast screening aims to detect breast cancers in asymptomatic women, thereby enabling intervention at an early stage of disease and gaining better survival outcomes.4 Australian governments have made early detection of breast cancer a priority, with the BreastScreen Australia program receiving funding support from Commonwealth and state/territory governments since 1990. The program originally focused on biennial screening of women aged 50–69 years, but the Federal Budget in 2013-14 enabled extension of the BreastScreen Australia program from July 2013 to actively invite additional women aged 70–74 years. Participation data are reported for the target age range of 50–74 years for the 2-year period 2014–15, onwards.3
Current status
During 2018-2019, over one in three Aboriginal and Torres Strait Islander females within the target age range participated in breast screening. The age-standardised participation rate for Aboriginal and Torres Strait Islander females aged 50–74 years during this period was 38.3%.1 During 2017-2018, crude participation rates were higher among females aged 60–64 years (41.3%) and 65–69 years (43.5%) than among females aged 50–54 years (32.4%), 55–59 years (36.4%), and 70–74 years (39.2%).1
Trends
The age-standardised participation rate among Aboriginal and Torres Strait Islander females in the target age range 50–74 years increased from 37.6% in 2017–2018 to 38.3% in 2018–2019.1
From 1996–1997 to 2018–2019, the age-standardised participation rate for Aboriginal and Torres Strait Islander females aged 50–69 years (which was the target age range of BreastScreen Australia up to 2013) increased by more than 10% in absolute terms (from 25.0% in 1996–1997 to 38.0% in 2018–2019).1,4
Addressing barriers to screening
Breast screening rates were lower in 2018–2019 among Aboriginal and Torres Strait Islander females aged 50–74 (38.3%), compared to other Australian females (54.4%).1 Lower participation rates may reflect a decrease in opportunities to access screening or a difference in screening behaviour. There may also be a degree of under reporting of Aboriginal and Torres Strait Islander women in BreastScreen data.1
To address barriers to screening and increase participation rates among Aboriginal and Torres Strait Islander women, BreastScreen Australia has co-designed materials and communications activities in consultation with Aboriginal and Torres Strait Islander women.1,4 These activities were designed to be: culturally sensitive and appropriate to knowledge, attitudes and beliefs; to include group bookings for those Aboriginal and Torres Strait Islander women who would prefer to attend as a group; and to include the use of cultural shawls and Indigenous artwork to make screening venues more welcoming.1,4
About the data
This measure shows the proportion of women aged 50–74 years screened through BreastScreen Australia in a rolling 2-year period. Data for women aged 50–69 years (the previous target age range) are also shown.
Numerator: Number of women in the target age range having received a mammogram through the national screening program over a 24-month period.
Denominator: Average number of female residents in the target age range during the 2-year reporting period.
Historical data presented for participation in BreastScreen Australia have been updated, data from 2001–2002 to 2016–2017 may differ from previously published data.
Methodology
Rates are the number of breast cancers per 100,000 women and are age-standardised to the Australian population at 30 June 2001 unless otherwise specified.
Note that participation is measured over 2 years to align with the 2-year recommended screening interval. A result of measuring rolling participation over 2 years on an annual basis is that there is an overlap between consecutive rates.
Caveats:
The BreastScreen program only aims to include asymptomatic women aged 50–74 years.
Indigenous status is self-reported by women at the time of their screening. The data do not include women in the 'not stated' category. Caution is advised when interpreting these data due to potential for variation in self reporting.
Breast cancer incidence data by Indigenous status are included for New South Wales, Victoria, Queensland, Western Australia, and the Northern Territory, and mortality data are included for New South Wales, Queensland, Western Australia, South Australia, and the Northern Territory.
Data sources
- Australian Institute of Health and Welfare 2021. BreastScreen Australia monitoring report 2021. Cat. no. CAN 140. Canberra: AIHW
- Australian Institute of Health and Welfare 2020. BreastScreen Australia monitoring report 2020. Cancer series no. 129. Cat. no. CAN 135. Canberra: AIHW
- Australian Institute of Health and Welfare 2019. BreastScreen Australia monitoring report 2019. Cancer series no. 127. Cat. no. CAN 128. Canberra: AIHW
- Australian Institute of Health and Welfare 2018. BreastScreen Australia monitoring report 2018. Cancer series no. 112. Cat. no. CAN 116. Canberra: AIHW
- Australian Institute of Health and Welfare 2017. BreastScreen Australia monitoring report 2014–2015. Cancer series no. 106. Cat. no. CAN 105. Canberra: AIHW
- Australian Institute of Health and Welfare 2016. BreastScreen Australia monitoring report 2013–2014. Cancer series no. 100. Cat. no. CAN 99. Canberra: AIHW
- Australian Institute of Health and Welfare 2015. BreastScreen Australia monitoring report 2012–2013. Cancer series no.95. Cat. no. CAN 93. Canberra: AIHW
References
Data:
Australian Institute of Health and Welfare 2021. BreastScreen Australia monitoring report 2021. Cat. no. CAN 140. Canberra: AIHW
Previous BreastScreen Australia monitoring reports accessible at: https://www.aihw.gov.au/reports/cancer-screening/breastscreen-australia-monitoring-report-2020/report-editions
Australian Institute of Health and Welfare 2018. Cancer in Aboriginal & Torres Strait Islander people of Australia. AIHW, Australian Government. Accessed December 2021; https://www.aihw.gov.au/reports/cancer/cancer-in-indigenous-australians
Policy:
Commonwealth Department of Health and Ageing. Evaluation of the BreastScreen Australia Program – Evaluation Final Report – June 2009. Screening Monograph No.1/2009. Canberra: Commonwealth of Australia; 2009. Accessed November 2021. Available from:https://www.health.gov.au/sites/default/files/documents/2021/10/breastscreen-australia-program-evaluation-of-target-age-expansion-final-report.pdf
Cancer Australia. National Aboriginal and Torres Strait Islander Cancer Framework. 2015 Available from: https://canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/overlay-context=affected-cancer/aboriginal-and-torres-strait-islander-people/national-aboriginal-and-torres-strait-islander-cancer-framework
Cancer Australia. Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer. 2018 Available from: https://canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/optimal-care-pathway-aboriginal-and-torres-strait-islander-people-cancer
References
1. Australian Institute of Health and Welfare 2021. BreastScreen Australia monitoring report 2021. Cat. no. CAN 140. Canberra: AIHW
2. Tapia KA, Garvey G, Mc Entee M, Rickard M, Brennan P. Breast cancer in Australian Indigenous women: incidence, mortality, and risk factors. Asian Pacific journal of cancer prevention: Asian Pac J Cancer Prev. 2017; 18(4): 873–884. doi: 10.22034/APJCP.2017.18.4.873
3. Australian Institute of Health and Welfare 2021. Cancer in Australia 2021. Cancer series no.133. Cat. no. CAN 144. Canberra: AIHW.
4. Australian Institute of Health and Welfare 2019. BreastScreen Australia monitoring report 2019. Cancer series no. 127. Cat. no. CAN 128. Canberra: AIHW