The age-standardised participation of females aged 50–74 years remained stable between 53.2% and 54.2% from 2014–2015 to 2018–2019, but then decreased in 2019–2020 to 49.4% and 47.1% in 2020-2021. This rate then tended to increase marginally to 49.6%.^1,5-11The drop in 2019-2021 was potentially affected by the COVID-19 pandemic since March 2020. BreastScreen Australia services were suspended nationwide from 25 March 2020. While recommencing about a month later, a staged approach was common involving longer appointment times and a range of precautionary measures to protect the safety of screening participants and staff.

Similarly, among females aged 50–69 years, the age-standardised participation tended to increase marginally from 53.9% in 2014–2015 to 54.6% in 2015–2016, and then remaining steady in 2018-2019 (53.9%) before decreasing to 48.8% in 2019-2020 and 46.5% in 2020-2021.⁵ This variation likely was affected by the COVID-19 pandemic. The rate increased again in 2021-22 to 49.2%.^1,5-11

Age groups

From 2014-15 to 2020-2021, the highest participation rate was reported in women aged 65-69 years), whereas the lowest was for ages 50-54 years. Participation rates for females aged in their early 60s remained relatively stable over time despite a decline in participation since 2018-2019. The data indicate a potential for a slight increase in participation at ages 70–74 years, from 49.1% in 2014-2015 to 50.6% in 2020–2021, which is now higher than the participation for ages 50–54 years.^1,5-11

Aboriginal and Torres Strait Islander peoples

The recorded age-standardised BreastScreen participation rate among Indigenous females in the target age range of 50–74 years appeared to increase slightly from 33.7% in 2014–2015 to 34.9% in 2020-2021. This participation rate reached 38.3% in 2018–2019 and declined to 35.8% in 2019-20, potentially affected by the impact of COVID-19. This was a similar pattern of decline to that seen for non-Indigenous women aged 50-74 years (from 54.4% in 2018-2019 to 49.5% in 2019-2020).^1,5-11

Aboriginal and Torres Strait Islander women have had consistently lower participation rates than non-Indigenous women.

Remoteness and socioeconomic status (SES)

Participation rates by remoteness area of residence are available for the 2-year periods 2014–2015, 2015–2016, 2016–2017, 2017-2018, 2018-2019 and 2019-2020 for females in the target age range of 50–74 years. Across these periods, participation was lowest in Very remote and highest in Outer regional areas. Females living in major cities had the second lowest participation of the remoteness quintiles in BreastScreen participation in the period between 2014 and 2021.^1,5-11 

Between 2014 and 2021, there was little variation in participation for women aged 50–74 years across socioeconomic (SES) areas. Participation rates remained the lowest in the most disadvantaged SES area, and highest in the second highest SES areas.

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 100.2 per 100,000 in 1991, to 125.6 per 100,000 in 2019, and was projected to be 128.6 per 100,000 in 2023.¹² Meanwhile there was a significant decrease in the age-standardised breast cancer mortality rate in females from 31.2 per 100,000 in 1991 to 18.2 per 100,000 in 2021, and with a projected 18.1 per 100,000 for 2023.¹³An increase in 5-year relative survival was reported in females from 78.3% in 1990–1994 to 92.0% in 2015–2019.¹⁴

Research shows that 55.3% of breast cancers detected by BreastScreen Australia are classified as small, compared with 27.6% of breast cancers detected in women who have never screened through BreastScreen Australia.⁴ Further, treatment of breast cancers detected by BreastScreen Australia are more likely to include breast-conserving surgery (74%, compared with 56% of breast cancers detected outside the program) (NBOCC 2009), which is thought to be associated with a decrease in morbidity.¹