Breast screening rates

Published

05 Nov, 2018

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

Summary

More than half of women in the target age-range participated in BreastScreen AustraliaIn 2015–16, the age-standardised participation rate for women in the target age-range of 50–74 years was 54.3%.

Breast screening participation rates are lower among Indigenous females than among non-Indigenous femalesIn 2015–16, the age-standardised breast screening participation rate for Indigenous females aged 50–74 years (39.1%) was lower than for non-Indigenous females (54.3%).

By remoteness, breast screening participation rates are lowest among women living in Very remote areasIn 2015–16, age-standardised participation rates were lowest among females aged 50–74 years living in Very Remote areas (44.1%), followed by residents of Remote areas (53.0%), Major Cities (53.3%), Inner Regional areas (56.5%) and Outer Regional areas (56.9%).

Data

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Notes

• Data sourced from AIHW BreastScreen Australia monitoring report 2018.
• Rates are age-standardised to the 2001 Australian population.

Proportion of women in target age range screened through BreastScreen Australia in a 2-year period, 1996–1997 to 2015–2016
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Notes

• Data sourced from AIHW BreastScreen Australia monitoring report 2018.
• Rates are unadjusted.

Proportion of women screened through BreastScreen Australia in a 2-year period, by age group
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Notes

• Indigenous status is self-reported. Data does not include women in the 'not stated' category.
• Data sourced from Australian Institute of Health and Welfare BreastScreen Australia monitoring report 2018.
• Rates are age-standardised to the 2001 Australian population.

Proportion of women aged 50-74 years screened through BreastScreen Australia in a 2-year period, by Indigenous status
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Notes

• Indigenous status is self-reported. Data does not include women in the 'not stated' category.
• Data sourced from Australian Institute of Health and Welfare BreastScreen Australia monitoring report 2018.
• Rates are age-standardised to the 2001 Australian population.

Proportion of women in target age range screened through BreastScreen Australia in a 2-year period, by Indigenous status
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2-year period

Notes

• Data sourced from AIHW BreastScreen Australia monitoring reports; error bars indicate 95% margin of error (available for 2012-2013 only).
• Rates are age-standardised to the 2001 Australian population.
• Remoteness areas were assigned using the woman’s residential postcode according to the Australian Statistical Geography Standard (ASGS) for 2011.

Proportion of women in the target age range screened through BreastScreen Australia in a 2-year period, by remoteness
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2-year period

Notes

• Data sourced from AIHW BreastScreen Australia monitoring reports; error bars indicate 95% margin of error (available for 2012-2013 only).
• Rates are age-standardised to the 2001 Australian population.
• Women were allocated to a socioeconomic group using their residential postcode according to the Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-Economic Disadvantage for 2011.

Proportion of women in target age range screened through BreastScreen Australia in a 2-year period, by socioeconomic status
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Notes

• Data sourced from OECD.Stat (Ref 5)
• Most recent year: 2017 (New Zealand, UK); 2016 (Australia, Denmark, Finland, France, Ireland, Korea, Norway); 2015 (Chile, Germany, Netherlands); Rates are not age-standardised.
• Some countries have different target age ranges: Chile and Ireland (aged 50–64 years); United Kingdom (includes those aged 53–69 years for England, and aged 53–70 years for Wales and Northern Ireland).
• Data for Denmark apply to 2 of 5 regions and for the United Kingdom to 3 of 4 countries.

Proportion of women in target age range participating in breast screening (programme data), by selected country

About this measure

Breast cancer is the most common cancer recorded in Australian women by Australian Cancer Registries. It is projected that in 2018, 18,087 females and 148 males will be diagnosed with this disease, and that it will remain the 4^th most common cause of death from cancer.²It is also estimated, using these data, that the risk of a female in Australia dying from breast cancer by her 85^th birthday will be about 1 in 41.²

Breast screening aims to detect breast cancers in asymptomatic women, thereby enabling intervention at an early stage of disease and, as a result, better survival outcomes.¹Australian 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 allowed for extension of the BreastScreen Australia program from July 2013 to actively invite 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.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 2015–16, 54.3% of women aged 50–74 years participated in the BreastScreen Australia program (age-standardised data).^4,6 Participation rates were higher among women aged 60–64 years (58.8%) and 65–69 years (60.2%) than among women aged 50–54 years (50.0%), 55–59 years (53.2%), and 70–74 years (53.0%).^4,6

The most recent data available for participation by Indigenous status, remoteness, and socioeconomic status, are for the period 2015–2016.

Aboriginal and Torres Strait Islander peoples

In 2015–16, the age-standardised participation rate for Indigenous females aged 50–74 years (39.1%) was lower than for their non-Indigenous counterparts (54.3%).^4,6

Remoteness and socioeconomic status (SES)

In 2015–16, age-standardised participation rates were lowest among females aged 50–74 years living in Very Remote areas (44.1%), followed by residents of Remote areas (53.0%), Major Cities (53.3%), Inner Regional areas (56.5%) and Outer Regional areas (56.9%).^4,6 In 2009, the Department of Health attributed some of the differences by remoteness area at that time to relative screening capacity between different areas.³

In contrast to participation rates by remoteness area, there were lower variations in age-standardised participation rates in 2015–16 by socioeconomic status. Participation rates were lowest among females aged 50–74 years living in the lowest SES areas (51.8%, SES 1), and varied between 54.3% (SES 3) and 55.2% (SES 5) in the other SES areas.^4,6

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).

Trends

The age-standardised participation rate of women in the age range 50–74 years increased from 53.2% in 2014–15 to 54.3% in 2015–16.^4,6Among women in the previous target age range of 50–69 years, the age-standardised participation rate had fluctuated between approximately 51.7% and 57.6% since 1996–1997, but increased from 53.7% in 2013–14 to 54.6% in 2015–16.^4,6

One of the reasons identified by the Department of Health in 2009 for the relatively stable participation rate over time for women aged 50–69 years is a potential shortfall in screening capacity – especially of the radiography workforce – and increasing demand from population growth within the target age range.³

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 60s remained relatively stable over that time. The most recent data (2015–16) for each age group shows an increased participation rate compared to 2014–15, with the largest increase occurring among females aged 70–74 years. This is due in part to the phasing in of targeting resources for this age group, as well as established screening habits, and potentially lesser work and family commitments.^4,6

Aboriginal and Torres Strait Islander peoples

Trend data are only available for females aged 50–69 years. From 1996–1997 to 2015–16, the age-standardised participation rate for Indigenous females aged 50–69 years increased by more than 50% (from 25.0% in 1996–1997 to 39.4% in 2015–16). Over the same period, the participation rate for non- Indigenous females aged 50–69 years increased from 39.8% to 54.6%.^4,6

Remoteness and socioeconomic status (SES)

Participation rates by remoteness area are available for the 2-year periods 2012–13 and 2013–14 for women in the target age range 50–69 years, and for the 2-year periods 2014–15 and 2015–16 for women 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 socioeconomic status are also available for the 2-year periods 2012–13 and 2013–14 for women in the target age range 50–69 years, and for the 2-year periods 2014–15 and 2015–16 for women in target age range 50–74 years. Across these periods, there were small differences in participation rates by socioeconomic status. Nonetheless, participation rates were consistently lower in the lowest SES area (SES 1).

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 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 31.3 per 100,000 in 1991 to 20.1 per 100,000 in 2015 – a 36% reduction – see Cancer mortality) and an increase in 5-year survival rate (from 85.9% in 1995–1999 to 92.5% in 2010–14).² In conjunction with other breast cancer awareness programs, BreastScreen Australia has increased numbers of breast cancers detected at an early stage, leading to better treatment and mortality outcomes.^1,3

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 (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.

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, as most women will only screen once within a 2-year period. A consequence of measuring participation over 2 years on an annual basis is that there are ‘rolling’ participation rates, in which there is an overlap of 1 calendar year between any 2 consecutive rates.

Caveats:

The program only includes asymptomatic women aged 50–74 years.

Caution should be applied to international comparisons as it is not known to what extent mammography outside of the organised screening programs will affect the participation rate for each country. Chile includes data from outside the organised screening program.

Other data quality issues:

For the international comparison, the OECD indicator definition is: ‘the number of women 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 women aged 50–69 eligible for an organised screening programme’.

The most recent year for data available by country is as follows:

Finland	2016
Denmark	2016
Netherlands	2015
Ireland	2016
United Kingdom	2017
Norway	2016
New Zealand	2017
Korea	2016
Australia	2016
Germany	2015
France	2016
Chile	2015

Data sourced from OECD.Stat (Ref 5)
Rates are not age-standardised.
Some countries have different target age ranges: Chile and Ireland (aged 50–64 years); United Kingdom (includes those aged 53–69 years for England, and aged 53–70 years for Wales and Northern Ireland).
Different methodology was used for Ireland
Rates for Finland and the Netherlands were estimated rates
Data for Denmark apply to 2 of 5 regions and for the United Kingdom to 3 of 4 countries.

Data sources

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. AIHW cancer screening publications: Accessed October 2018; https://www.aihw.gov.au/reports-statistics/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 2017; http://cancerscreening.gov.au/internet/screening/publishing.nsf/Content/programme-evaluation.

References

1. Australian Institute of Health and Welfare 2016. BreastScreen Australia monitoring report 2013–2014. Cancer series no. 100. Cat. no. CAN 99. Canberra: AIHW.

2. Cancer Australia 2017. Breast cancer statistics. Accessed November 2017. 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. Australian Institute of Health and Welfare 2017. BreastScreen Australia monitoring report 2014–2015. Cancer series no. 106. Cat. no. CAN 105. Canberra: AIHW

5. OECD.Stat. Accessed November 2017; http://stats.oecd.org/

6. Australian Institute of Health and Welfare 2018. BreastScreen Australia monitoring report 2018. Cancer series no. 112. Cat. no. CAN 116. Canberra: AIHW.

Revision Type

Minor

Version Number

1.1

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Summary

More than half of women in the target age-range participated in BreastScreen Australia

Breast screening participation rates are lower among Indigenous females than among non-Indigenous females

By remoteness, breast screening participation rates are lowest among women living in Very remote areas

Data