Published 03 Jun, 2022

The proportion of women recalled for assessment due to an abnormal breast screen is a key performance indicator in the national breast screening program. To ensure that all women receive high quality breast screening services, BreastScreen Australia’s National Accreditation Standards (NAS) require the monitoring and reporting of the proportion of women aged 50–74 years among those who attend for their first screening episode, and among those who attend for their second or subsequent screening episode, who are recalled for assessment.1

    Charts

    Breast cancer is the most common cancer reported in Australian females by Australian cancer registries. It is estimated that in 2021, 19,866 females and 164 males will be diagnosed with this cancer, and that it will be the fifth most common cause of death from cancer.2 It is also estimated, using these data, that the risk of a female in Australia dying from breast cancer by her 85th birthday will be about 1 in 52.2

    Breast screening aims to detect breast cancers in asymptomatic females to enable intervention at an early stage of disease and, as a result, gain better survival outcomes.1A breast screen which shows suspicious signs of breast cancer will generally lead to a recall of the woman for further investigation by a multidisciplinary team at an assessment centre.1 Recall to assessment rates are generally analysed separately for first and subsequent screening rounds because females are more likely to be recalled to assessment after their first breast screen than after subsequent screens.1

    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 females aged 50–69 years, but the Federal Budget in 2013-14 supported extension of the BreastScreen Australia program from July 2013 to also invite females aged 70–74 years. Recall to assessment data are reported for the target age range of 50–74 years from 2014 onwards.

    In 2019, 11.7% of females aged 50–74 years were recalled for further investigation (assessment) after their first breast screen (age-standardised data). For females aged 50–74 years who were attending a second or later (subsequent) screen, 3.7% were recalled for further assessment.1

    The recall to assessment rate was similar across the different age groups in the target age range for both first and subsequent breast screens.1

    This measure shows the proportion of females aged 50–74 years recalled to assessment following screening through BreastScreen Australia, on an annual basis. Data for females aged 50–69 years (previous target age range) are also shown.

    Numerator: Number of females in the target age range recalled for assessment following their first screen, or a subsequent screen, in a single year.

    Denominator: Number of females in the target age range years receiving a first screen, or a subsequent screen, in that single year.

    Data sources:

    • Australian Institute of Health and Welfare. AIHW Breast cancer screening publications: Accessed November 2021; https://www.aihw.gov.au/reports-data/health-welfare-services/cancer-screening/reports
    • 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. 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.
    • Australian Institute of Health and Welfare 2014. BreastScreen Australia monitoring report 2011–2012. Cancer series no. 86. Cat. no. CAN 83. Canberra: AIHW.
    • Australian Institute of Health and Welfare 2013. BreastScreen Australia monitoring report 2010–2011. Cancer series no. 77. Cat. no. CAN 74. Canberra: AIHW.
    • Australian Institute of Health and Welfare 2011. BreastScreen Australia Monitoring Report 2008-2009. Cancer series no. 63. Cat. no. CAN 60. Canberra: AIHW.
    • Health and Social Care Information Centre 2021. Breast Screening Programme, England 2019-20. Accessed November 2021; https://digital.nhs.uk/data-and-information/publications/statistical/breast-screening-programme/

    Methodology:

    Rates are age-standardised, unless otherwise specified.

    Assessment recall, over time data is age-standardised to the population of women attending a BreastScreen Australia service.

    Caveat:

    Caution should be applied to the international comparison between Australia and England due to the modified age groupings reported by the Health and Social Care Information Centre. Data from the Breast Screening Programme England report5 for the period 2013-14 and onwards includes females aged 45 and over. Data presented in the charts represent females aged 50-70.

    Activity in this area

    Data:

    Australian Institute of Health and Welfare. AIHW cancer screening publications: Accessed November 2021; https://www.aihw.gov.au/reports-data/health-welfare-services/cancer-screening/reports

    Policy:

    ommonwealth Department of Health. BreastScreen Australia, Policy. Accessed December 2021; http://cancerscreening.gov.au/internet/screening/publishing.nsf/Content/policy:

     

    References

    1. Australian Institute of Health and Welfare 2021. BreastScreen Australia monitoring report 2021. Cat. no. CAN 140. Canberra: AIHW. Canberra: AIHW.

    2. Australian Institute of Health and Welfare 2019. Cancer in Australia 2019. Cancer series no.119. Cat. no. CAN 122.

    3. Cancer Australia 2020. Breast cancer Australia statistics. Accessed November 2021; https://www.canceraustralia.gov.au/cancer-types/breast-cancer/statistics  

    4. BreastScreen WA 2012. BreastScreen WA Statistical Report 2006–2010. Perth: Department of Health WA.

    5. NHS Digital 2021. Breast screening programme, England 2019-20. Accessed November 2021; https://digital.nhs.uk/data-and-information/publications/statistical/breast-screening-programme

     

    Summary

    Just over one in ten females are recalled for further investigation after their initial breast screen

    In 2019, 11.7% of females in the target age range of 50–74 years were recalled for further investigation (assessment) after their first breast screen.

    Recall to assessment rates after initial screening have increased since 1996

    Among females in the age range of 50–69 years, recall to assessment rates after a first screen increased from 5.8% in 1996 to 12.2% in 2014, although subsequently decreasing a little to 11.1% in 2018 and to 11.7% in 2019. The increase since 1996 was accompanied by an increase in the detection rate of invasive breast cancers.