Trend data is only available for females aged 50–69 years. From 1996 to 2015, the proportion of females in the target age range who were recalled to assessment after their first breast screen increased from 5.8% in 1996 to 11.7% in 2015 (age-standardised data). Over the same time period, the proportion of women aged 50–69 years being recalled to assessment after a subsequent screen remained relatively stable, in the range of 3.2–4.2% (age-standardised).
Analysis of recall rates by age groups in the target age range showed that, in most years, the recall to assessment rate was highest amongst women in the 50–54 years age group. This observation may be due to the fact women in the younger age group tend to have denser breast tissue which make lesions more difficult to distinguish during screening.4 The increase in recall to assessment rates from 1996 to 2014 was similar for all age groups.
For women attending a subsequent screen, higher recall to assessment rates were also observed for the 50–54 years age group, but with little observed change in rates between 1996 and 2015.
A comparison can be made with the NHS Breast Screening Programme (NHSBSP) in England, in which women in the age range of 50–70 years are invited to attend a breast screen every three years. In the ten-year period from 2004-05 to 2014-15, the recall for assessment rate after the first breast screen remained relatively stable, in the range of 7.7–8.9% in England compared to 10.2–11.8% in Australia (note: non age-standardised data). For subsequent screens, the recall to assessment rate was in the range of 2.8–3.5% in England compared to 3.8–3.9% in Australia. During this period, the detection rates for invasive, small invasive and all breast cancers in England remained almost unchanged at 8.1–8.3 cases per 100,000.5
Recall to assessment and breast cancer control in Australia
Since the introduction of BreastScreen Australia, the age-standardised incidence rate for female breast cancer has increased (from 109.7 per 100,000 in 1996, to 125.0 per 100,000 in 2014, see Cancer incidence). During this period, there has been a decrease in the age-standardised breast cancer mortality rate (from 28.8 per 100,000 in 1996 to 20.1 per 100,000 in 2015 – a 30% reduction – see Cancer mortality) and an increase in 5-year survival rate (from 81.4% in 1993–1997 to 90.2% in 2009–2013).2
The AIHW has observed that over the last 6-7 years, the increase in the recall to assessment rate led to an increase in detection of invasive breast cancers and ductal carcinoma in situ in women screening for the first time.1