Trend data are available for females aged 50–69 years from 1996, and for females aged 50–74 years from 2015. From 1996 to 2019, the proportion of females in this target age range who were recalled to assessment after their first breast screen increased from 5.8% in 1996 to 12.2% in 2014, but has since decreased a little to 11.1% in 2018 and 11.7% in 2019 (age-standardised data).1,3 Similarly, among females aged 50–74 years, the proportion recalled to assessment after the first breast screen decreased slightly from 11.8% in 2015 to 11.2% in 2018 and 11.7% in 2019.1,3
From 1996 to 2019, the proportion of females aged 50–69 years recalled to assessment after a subsequent screen remained relatively stable, in the range of 3.2-4.2% (age-standardised).1,3 Similarly, from 2015 onwards the proportion of females aged 50–74 years recalled to assessment after a subsequent screen varied between 3.5-3.8%.1,3
Analysis of recall rates by age groups in the target age range showed that the increase in recall to assessment rates from 1996 to 2019 was similar for most age groups. Since 2015, recall rates have been lowest among females age 60–64 years and highest among females aged 70–74 years.1
For females attending a subsequent screen, higher recall to assessment rates have been consistently observed for the 50–54 years age group [this observation may reflect the denser breast tissue in younger women which can make lesions more difficult to distinguish through screening].1,4 There has been little observed change in subsequent screen rates between 1996 and 2019.1
International comparison
A comparison can be made between recall to assessment data for BreastScreen Australia and the NHS Breast Screening Programme (NHSBSP) in England. In the ten-year period from 2009-10 to 2019-20, the recall to assessment rate for females aged 50-70 in the NHSBSP remained relatively stable after the first and subsequent breast screens. The recall to assessment rate after the first breast screen was in the range of 6.8-8.1% in England compared to 10.7-11.7% in Australia. For subsequent screens, the recall to assessment rate was in the range of 2.8-3.0% in England compared to 3.7-4.2% in Australia (note: not age-standardised). During this period, the detection rates for small invasive and all breast cancers in England remained almost unchanged at 8.0 cases per 1,000.5
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 100.4 per 100,000 in 1991, to 124.4 per 100,000 in 2015, see Cancer incidence). During this period, there has been a decrease in the age-standardised breast cancer mortality rate (from 31.3 per 100,000 in 1991 to 19.9 per 100,000 in 2016, see Cancer mortality) and an increase in 5-year survival rate (from 85.5% in 1997-2001 to 91.5% in 2013-17.2,3
The AIHW has observed that over time, the proportion of women attending a breast screening for the first time who were recalled to assessment has increased.1 This increase in recall to assessment rate has been accompanied by an increase in detection of invasive breast cancers and ductal carcinoma in situ in females screening for the first time.1