Cancer is a major cause of illness and death in Australia – there are over 1.2 million people alive in Australia who are either living with or have lived with cancer. Latest data (2015–2019) show that 7 in 10 people diagnosed with cancer survive at least 5 years after diagnosis, up from 5 in 10 around 30 years ago (AIHW 2023a).
Understanding and avoiding the risk factors associated with cancer can help to reduce the chance of getting the disease. Improvements in treatments and care are also important contributors to improvements in survival. Some cancers can be detected through screening. Cancer screening programs aim to reduce illness and death from certain cancers by allowing for early detection, intervention, and treatment.
This page focuses on cancer screening programs in Australia. For information on cancer incidence, mortality, prevalence, and survival, see Cancer.
What is cancer screening?
Population-based cancer screening involves testing for signs of cancer or conditions that cause cancer before a person has symptoms. Early detection of cancer allows for early intervention and treatment, which can improve outcomes.
In Australia, there are national population-based screening programs for breast, cervical, and bowel cancers. They are run through partnerships between the Australian Government and state and territory governments. The programs target certain groups where evidence shows that screening helps to reduce ill health and deaths from cancer.
Breast cancer screening
Breast cancer screening on this page refers only to breast cancer screening undertaken through BreastScreen Australia.
BreastScreen Australia began in 1991 targeting women aged 50–69. The inclusion of women aged 70–74 was phased in from 1 July 2013. The program provides free 2-yearly screening mammograms (see glossary) to women aged 40 and over, and actively targets women aged 50–74.
The term ‘participant’ is respectfully used to denote a person who has breast tissue that is suitable for breast cancer screening and who screens through BreastScreen Australia. Participants may include women, transgender men, transgender women, non-binary people, or other gender diverse people.
Participation in BreastScreen Australia
Over the 2 years 2021–2022, more than 1.8 million participants aged 50–74 were screened through BreastScreen Australia – 50% of the target population (AIHW 2023b).
The age-standardised participation rate remained between 53% and 54% from 2014–2015 to 2018–2019 and decreased to 49% and 47% in 2019–2020 and 2020–2021, respectively, due to the impact of the COVID-19 pandemic (AIHW 2023b).
Participation in BreastScreen Australia varied between population groups and across areas of Australia in 2020–2021:
- 35% of Aboriginal and Torres Strait Islander (First Nations) women aged 50–74 participated in BreastScreen Australia (25,000 participants). After adjusting for age, participation was 26% lower for First Nations women than for non-Indigenous women.
- 37% of women who spoke a language other than English at home participated in BreastScreen Australia (250,000 participants). After adjusting for age, participation was 25% lower for women who spoke a language other than English at home than women who spoke only English at home.
- After adjusting for age, participation was 31% higher for participants living in Outer regional areas than for participants living in Very remote areas (AIHW 2023b).
Detection of breast cancer
In 2021, almost 5,600 participants aged 50–74 had an invasive cancer detected through BreastScreen Australia and 59% of those breast cancers were small (≤15 mm). Small breast cancers are associated with more treatment options and improved survival (AIHW 2023b).
Cervical screening
People with a cervix are at risk of cervical cancer and are the eligible population for cervical screening. People with a cervix may include women, transgender men, intersex people, and non-binary people, hereafter respectively referred to as ‘people’ or ‘participants’.
All cervical screening is undertaken through the National Cervical Screening Program (NCSP).
From its commencement in 1991 to 30 November 2017, the NCSP offered 2-yearly Papanicolaou tests, or ‘Pap tests’ (see glossary) for the target age group 20–69.
Since December 2017, a renewed NCSP offers 5-yearly human papillomavirus (HPV) (see glossary) tests for the target age group 25–74. The cervical screening test (CST) (see glossary) detects the presence of cancer-causing HPV.
Participation in the National Cervical Screening Program
Over the 5 years 2018–2022, more than 5.2 million participants aged 25–74 were screened through the NCSP, which is an estimated 77% of the eligible population (AIHW 2023c).
Trend data are not yet available for participation in the renewed NCSP. However, towards the beginning of the COVID-19 pandemic (April 2020), there was a disproportionate drop in cervical screening tests not observed in later years over the same month (AIHW 2023c).
Participation in the NCSP varied between population groups and across areas of Australia in 2018–2022:
- After adjusting for age, participation was 16% higher for participants living in Major cities than for participants living in Very remote areas.
- After adjusting for age, participation was 20% higher for participants living in the highest socioeconomic areas than for participants living in the lowest socioeconomic areas (AIHW 2023c).
Detection of cervical abnormality
In 2022, for every 1,000 participants screened, 14 participants had a high-grade abnormality detected, providing an opportunity for treatment before possible progression to cervical cancer (AIHW 2023c).
Bowel cancer screening
Bowel cancer screening on this page refers to the screening managed by the National Bowel Cancer Screening Program (NBCSP).
The NBCSP was established in 2006, offering screening using a free immunochemical faecal occult blood test (iFOBT) (see glossary) to people at 2 target ages (55 and 65). In 2014, the Australian Government announced that the target ages would be expanded to offer 2-yearly screening to all Australians aged 50–74. This expansion was completed in 2020.
Participation in the National Bowel Cancer Screening Program
Over the 2 years 2021–2022, of the 6.0 million people invited, 40% participated in the program. Participation was higher for women than men (42% and 38%, respectively) (AIHW 2024).
Since the expansion of the program from 2014, the NBCSP participation rate increased from 39% in 2014–2015 to 44% in 2019–2020. There was a small decline in the participation rates following the COVID-19 pandemic to 41% in 2020–2021 and 40% in 2021–2022 (AIHW 2024).
Participation in the NBCSP varied between population groups and across areas of Australia in 2021–2022:
- The participation rate was highest for people living in Inner regional areas (42%) and lowest for people living in Very remote areas (26%).
- The participation rate was highest for people living in the highest socioeconomic areas (45%) and lowest for people living in the lowest socioeconomic areas (35%) (AIHW 2024).
Detection of bowel cancer
In 2022, 5.7% of participants aged 50–74 who returned a valid kit had a positive iFOBT test (see glossary). Of those with a positive result, 86% had record of a diagnostic assessment (colonoscopy) to follow up the positive screening result.
The return of NBCSP forms is not mandatory and as a result, diagnostic assessment data are incomplete. However, with the data available for participants who underwent a diagnostic assessment after a positive screen in 2022:
- 4.1% were diagnosed with a confirmed or suspected bowel cancer
- 14% were diagnosed with an adenoma (pre-cancerous tumour) (AIHW 2024).
First Nations people, as well as participants who lived in Very remote areas and participants who lived in low socioeconomic areas all had higher rates of positive screens (warranting further assessment), but lower rates of follow-up diagnostic assessment, and a longer median time between a positive screen and assessment (AIHW 2024).
How effective are the cancer screening programs?
National cancer diagnosis data do not reveal if a new case of cancer was identified through a screening program. This information can currently only be determined using data linkage. Linkage work conducted by the AIHW examined the effectiveness of the 3 national cancer screening programs on cancer mortality (AIHW 2018).
Key findings included:
- Women aged 50–69 who were diagnosed with a breast cancer through BreastScreen Australia between 2002 and 2012 had a 42% lower risk of dying from breast cancer by 2015 than women with breast cancers who had never been screened (AIHW 2018).
- Most cervical cancers diagnosed in women aged 20–69 between 2002 and 2012 (more than 70%) occurred in women who had never screened or who were lapsed screeners (AIHW 2018).
- People aged 50–69 who were diagnosed with a bowel cancer detected through the NBCSP between 2006 and 2012 had a 40% lower risk of dying from bowel cancer by 2015 than those with a bowel cancer who had not been invited to screen during the study period (AIHW 2018).
Further data linkage work is needed to continue to monitor cancer screening outcomes over time, and as more data become available. The AIHW is currently progressing 3 data linkage projects:
- one will provide more detailed analysis of breast screening behaviour and cancer outcomes, including among First Nations women
- a second will allow more complete monitoring of bowel and cervical screening programs as well as monitoring the impact of HPV vaccination
- another will examine adverse events after NBCSP-related colonoscopy.
Where do I go for more information?
For more information on cancer screening, see:
For more on this topic, visit Cancer screening and Cancer.
