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
Charts
About this measure
Breast cancer is the most common cancer recorded in Australian females by Australian Cancer Registries. It is estimated that in 2021, 19,866 females and 164 males will be diagnosed with this disease, 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, thereby enabling intervention at an early stage of disease and, as a result, better survival outcomes.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 allowed for extension of the BreastScreen Australia program from July 2013 to also actively invite females aged 70–74 years. Participation data are reported for the target age range of 50–74 years for the 2-year period 2014–2015, onwards.1
Included data relate to the BreastScreen Australia program. They exclude investigations using diagnostic mammography (most of which are supported through the Medicare Benefits Schedule (MBS)). Other mammograms occurring privately on a user-pays basis are also excluded. Data on screening outside the BreastScreen Australia program are not readily available, although it has been estimated that non-diagnostic mammograms covered by MBS support would increase the screening participation rate by about 3.5 percentage points.3
Current status
In the period 2018–2019, 54.2% of females aged 50–74 years participated in the BreastScreen Australia program (age-standardised data).1 Participation rates were higher among females aged 60–64 years (57.3%) and 65–69 years (59.6%) than among females aged 50–54 years (49.8%), 55–59 years (52.5%), and 70–74 years (56.3%).1
Aboriginal and Torres Strait Islander peoples
In the period 2018–2019, the age-standardised participation rate for Indigenous females aged 50–74 years (38.3%) was lower than for their non-Indigenous counterparts (54.4%).1
Remoteness and socioeconomic status (SES)
In the period 2018–2019, age-standardised participation rates were lowest among females aged 50–74 years living in Very Remote areas (41.6%), followed by residents of Remote areas (53.0%), Major Cities (53.1%), Inner Regional areas (57.0%), and Outer Regional areas (56.9%).1
In contrast to participation rates by remoteness area, there was little variation in age-standardised participation rates in 2018–2019 by SES area. The participation rate varied between 51.8% and 55.5%. The rate among females aged 50–74 years living in each SES area was: 51.8% (SES 1/most disadvantage), 55.5% (SES 2), 53.9% (SES 3), 55.1% (SES 4), and 54.8% (SES 5/least disadvantage).1
International comparisons
Although caution should be applied when comparing Australian and international rates, due to differences in screening programs, the participation rate for Australia appears to be generally lower than for most other developed countries with corresponding breast screening data (see Chart notes for the limitations of the international comparison).4
Trends
The age-standardised participation rate of females in the age range 50–74 years has remained steady at 54.5% in 2016–2017, after being 54.3% in 2015–2016 and 53.2% in 2014–2015.1 Among females in the previous target age range of 50–69 years, the age-standardised participation rate has fluctuated between approximately 51.7% and 57.6% since 1996–1997, but has increased slightly from 53.7% in 2013–2014 to 54.4% in 2016–2017, and has remained steady at 53.9% in 2018-2019.1
Age groups
A trend for declining age-specific participation rates had been apparent for females aged in their 50s since the early 2000s, although the most recent data indicates a reversal of this trend. By contrast, participation rates for females aged in their early 60s remained relatively stable over that time. The most recent data (2018–2019) for each age group shows a similar participation rate compared to 2015–2016, except a slight decline in participation for females aged 55-59 years and 60-64, and for females aged 70–74 years amongst whom participation has continued to increase since 2014–2015. This is due in part to the phasing in of target screening resources for this age group, as well as established screening habits, and potentially lesser work and family commitments.1
Aboriginal and Torres Strait Islander peoples
The age-standardised participation rate among Indigenous females in the target age range 50–74 years increased from 33.7% in 2014–2015 to 38.3% in 2018–2019. Among Indigenous females in the previous target age range of 50–69 years, the age-standardised participation rate has increased significantly (from 30.3% in 1998-1999 to 38.0% in 2018–2019). Over the same period, the participation rate for non-Indigenous females aged 50–69 years increased from 42.9% to 54.0%.1
Remoteness and socioeconomic status (SES)
Participation rates by remoteness area are available for the 2-year periods 2014–2015, 2015–2016, 2016–2017, 2017-2018, and 2018-2019 for females in the target age range 50–74 years. Across these periods, participation rates have been consistently lowest in Very Remote areas, and highest in Outer Regional areas.
Participation rates by SES area are also available for the 2-year periods 2014–2015, 2015–2016, 2016–2017, 2017-2018, and 2018-2019 for females in target age range 50–74 years. Across these periods, there were small differences in participation rates among SES 2, SES 4 and SES 5. Participation rates remained the lowest among SES 1, the most disadvantaged SES area, during 2014-2015 to 2018-2019.
Participation rates 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 2013–2017).2 In conjunction with other breast cancer awareness programs, BreastScreen Australia has increased numbers of breast cancers detected at an early stage, likely leading to more successful treatments and better mortality outcomes.1,3
About the data
This measure shows the proportion of females aged 50–74 years screened through BreastScreen Australia in a rolling 2-year period. Data for females aged 50–69 years (previous target age range) are also shown.
Numerator: Number of females 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.
Breast cancer incidence and mortality data relates to ICD-10-CM code C50 and does not include in-situ carcinoma.
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
Methodology:
Rates are age-standardised unless otherwise specified.
Note that participation is measured over 2 years to align with the 2-year recommended screening interval. Most females will only screen once within a 2-year period. A result of measuring participation over 2 years on an annual basis is that this leads to ‘rolling’ participation rates, in which there is an overlap of 1 calendar year between any 2 consecutive rates.
Caveats:
The program only targets asymptomatic females aged 50–74 years.
Caution should be applied in international comparisons as the extent of mammography outside of organised screening programs is not known and would affect overall participation rates for each country. Chile is explicit in including data from outside the organised screening program.
Data sourced from AIHW BreastScreen Australia monitoring reports; error bars indicate the 95% margin of random error (available for 2012-2013 only).
Previously reported data have since been updated in the 2021 BreastScreen Australia Monitoring Report, previously presented data may be reflective of these numbers.1
Remoteness
The Australian Statistical Geography Standard (ASGS) for 2011 was used to allocate participants to a remoteness area based on their area of usual residence.
Socioeconomic status (SES)
The Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-Economic Disadvantage (IRSD) for 2011 was used to allocate participants to a SES quintile based on their usual residence.
Other data quality issues:
For the international comparison, the OECD indicator definition is: ‘the number of females aged 50–69 who have received a bilateral mammography within the past two years (or according to the specific screening frequency recommended in each country) divided by the number of females aged 50–69 eligible for an organised screening programme’.
References
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/overview
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; https://www.health.gov.au/sites/default/files/documents/2021/10/breastscreen-australia-program-evaluation-of-target-age-expansion-final-report.pdf
References
1. Australian Institute of Health and Welfare 2021. BreastScreen Australia monitoring report 2021. Cat. no. CAN 140. Canberra: AIHW.
2. Cancer Australia 2019. Breast cancer statistics. Cancer Australia 2020. Accessed November 2021; https://breast-cancer.canceraustralia.gov.au/statistics
3. 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
4. OECD.Stat. Organisation for Economic Co-operation and Development. Accessed November 2021; http://stats.oecd.org/