Breast screening rates

Published

10 Jan, 2020

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 females in the target age range participated in BreastScreen AustraliaIn the period 2016–2017, the age-standardised participation rate for females in the target age-range of 50–74 years was 54.5%.

Breast screening participation rates are lower among Indigenous females than among non-Indigenous femalesIn the period 2016–2017, the age-standardised breast screening participation rate for Indigenous females aged 50–74 years (40.7%) was lower than for non-Indigenous females (54.2%).

Breast screening participation rates are lowest among females living in Very Remote areasIn the period 2016–2017, age-standardised participation rates were lowest among females aged 50–74 years living in Very Remote areas (43.4%), followed Remote areas (52.6%), Major Cities (53.4%), Inner Regional areas (55.9%), and Outer Regional areas (57.0%).

Data

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Notes

• Data sourced from AIHW BreastScreen Australia monitoring reports.
• Rates are age-standardised unless otherwise specified.

Proportion of women in target age range screened through BreastScreen Australia in a 2-year period, 1996–1997 to 2016–2017
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Notes

• Data sourced from AIHW BreastScreen Australia monitoring reports.
• 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 AIHW BreastScreen Australia monitoring reports.
• Rates are age-standardised unless otherwise specified.

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 AIHW BreastScreen Australia monitoring reports.
• Rates are age-standardised unless otherwise specified.

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

• Rates are age-standardised unless otherwise specified.
• 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 (50-74 years) screened through BreastScreen Australia in a 2-year period, by remoteness
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Notes

• Rates are age-standardised unless otherwise specified.
• 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
• Most recent year: 2018 (New Zealand, UK); 2017 (Finland, France, Ireland, Korea, Norway); 2016 (Australia, Chile, Denmark, Germany); 2015 (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 females by Australian Cancer Registries. It is projected that in 2019, 19,535 females and 164 males will be diagnosed with this disease, and that it will remain the fourth 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 43.²

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.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 females 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 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 2016–2017, 54.5% 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 (58.5%) and 65–69 years (60.1%) than among females aged 50–54 years (49.7%), 55–59 years (53.1%), and 70–74 years (55.0%).¹

Aboriginal and Torres Strait Islander peoples

In the period 2016–2017, the age-standardised participation rate for Indigenous females aged 50–74 years (40.7%) was lower than for their non-Indigenous counterparts (54.2%).¹

Remoteness and socioeconomic status (SES)

In the period 2016–2017, age-standardised participation rates were lowest among females aged 50–74 years living in Very Remote areas (43.4%), followed by residents of Remote areas (52.6%), Major Cities (53.4%), Inner Regional areas (55.9%), and Outer Regional areas (57.0%).¹

In contrast to participation rates by remoteness area, there was little variation in age-standardised participation rates in 2016–2017 by SES area. The participation rate varied between 51.7% and 55.7%. The rate among females aged 50–74 years living in each SES area was: 54.0% (SES 1), 55.7% (SES 2), 51.7% (SES 3), 55.5% (SES 4), and 55.2% (SES 5).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 2014–2015.¹Among 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 2016–2017.¹

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 (2016–2017) for each age group shows a similar participation rate compared to 2015–2016, except 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 targeting 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 37.3% in 2014–2015 to 40.7% in 2016–2017. Among Indigenous females in the previous target age range of 50–69 years, the age-standardised participation rate increased by more than 50% (from 25.0% in 1996–1997 to 40.8% in 2016–2017). Over the same period, the participation rate for non- Indigenous females aged 50–69 years increased from 39.8% to 54.1%.¹

Remoteness and socioeconomic status (SES)

Participation rates by remoteness area are available for the 2-year periods 2014–2015, 2015–2016, and 2016–2017 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, and 2016–2017 for females in target age range 50–74 years. Across these periods, there were small differences in participation rates by SES area.

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 19.8 per 100,000 in 2016, see Cancer mortality) and an increase in 5-year survival rate (from 85.9% in 1995–1999 to 90.8% in 2011–2015).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 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.

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 females 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 females 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.

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’.

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

Finland	2017
Denmark	2016
Netherlands	2015
Ireland	2017
United Kingdom	2018
Norway	2017
New Zealand	2018
Korea	2017
Australia	2016
Germany	2016
France	2017
Chile	2016

Data sourced from OECD.Stat
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 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

References

Activity in this area

Data:

Australian Institute of Health and Welfare. AIHW cancer screening publications: Accessed October 2019; 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 2019. BreastScreen Australia monitoring report 2019. Cancer series no. 127. Cat. no. CAN 128. Canberra: AIHW.

2. Cancer Australia 2019. Breast cancer statistics. Accessed October 2019. 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. Accessed November 2019; http://stats.oecd.org/

Revision Type

Minor

Version Number

1.2

National Cancer Control Indicators

Breast screening rates

Summary

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

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

Breast screening participation rates are lowest among females living in Very Remote areas

Data

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Summary

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

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

Breast screening participation rates are lowest among females living in Very Remote areas

Data

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NCCI – About the Data