Summary

Cancer screening involves testing for signs of cancer or precancerous conditions in people without obvious symptoms. BreastScreen Australia is one of Australia’s three population-based cancer screening programs. It aims to reduce illness and death from breast cancer through an organised approach to the early detection of breast cancer, using screening mammography to detect unsuspected breast cancer in women. Early detection provides an opportunity for early treatment, which can reduce illness and death.

BreastScreen Australia provides free 2-yearly screening mammograms to women aged 40 and over, and actively targets women aged 50–74.

This report is the latest in the annual BreastScreen Australia monitoring report series and presents the latest data available for each performance indicator.

Terminology

This document uses the terms ‘participant’ and ‘participants’ when referring to data collected under BreastScreen Australia. These data are not restricted by sex or gender, with all participants in breast screening included in these data. 

For breast cancer screening data, ‘participant’ or ‘participants’ is defined as a person having breast tissue that is suitable for breast cancer screening and who has engaged BreastScreen Australia through a screening and/or assessment appointment or visit.

Screening participants may include women, transgender men, transgender women, non-binary people or other gender diverse people. State and territory BreastScreen services provide advice on BreastScreen and gender, including whether screening for breast cancer may benefit transgender women, transgender men, non-binary, and gender diverse people.

This document uses the term 'women' to mean ‘female' when referring to cancer incidence data and cancer mortality data, as these data sources are based on sex assigned at birth. However, it should be noted that some people may not identify with this term.

This document uses the term ‘breast’ to refer to the tissue affected by breast cancer. While the term ‘breast’ may be used as a gendered word in some instances, its use in this report is non-gendered and medical.

Recruitment

The most recent complete participation data are for participants who had a screening mammogram in the years 2021 and 2022, with preliminary data for the years 2022 and 2023.

Over the 2 years 2022–2023, more than 1.9 million participants aged 50–74 were screened through BreastScreen Australia – 52% of the target population. This was a little higher than the more than 1.8 million who screened over the 2 years 2021–2022, which was 50% of the target population.

Prior to these years, the age-standardised participation rate remained between 53% and 54% from 2014–2015 to 2018–2019 before decreasing to 49% and 47% in 2019–2020 and 2020–2021, respectively, due to the impact of the COVID-19 pandemic. Thereafter, age-standardised participation increased to 50% in 2021–2022 and 51% in 2022–2023.

The proportion of participants aged 50–72 who rescreened within 27 months was 51% after having their first screen through BreastScreen Australia in 2020, 60% after their second screen in 2020, and 76% after having their third or higher screen in 2020. Similar to participation, rescreening has also decreased due to the impact of the COVID-19 pandemic.

Screening

BreastScreen Australia aims to maximise the detection of breast cancers while minimising the number of unnecessary investigations. Participants are recalled to assessment for further investigation if their screening mammogram is found to be suspicious for breast cancer.

In 2022, 11% of participants aged 50–74 who screened for the first time, and 4% of participants aged 50–74 attending a subsequent screen, had a screening mammogram result indicating they should be recalled for further investigation.

These recall to assessment rates are similar to those in 2021.

Diagnosis

BreastScreen Australia aims to maximise the detection of invasive breast cancers, particularly small cancers, to achieve the desired reductions in morbidity and mortality.

In 2022, 5,881 participants aged 50–74 had an invasive breast cancer detected through BreastScreen Australia. Invasive breast cancer detection rates in 2022 for participants aged 50–74 were:

  • 103 per 10,000 participants screened for the first time
  • 57 per 10,000 participants attending a subsequent screen

Invasive breast cancer detection is higher for participant’s who screen for the first time because a participant’s first visit detects prevalent cancers that may have been present for some time rather than incident cancers that have grown between screens.

Small breast cancers (≤15 mm in diameter) tend to be associated with more treatment options, lower morbidity and improved survival.

In 2022, 3,386 participants aged 50–74 had a small (≤15 mm) invasive breast cancer detected through BreastScreen Australia. This was equivalent to 44% of invasive breast cancers detected in participants attending their first screen, and 60% of invasive breast cancers detected in those attending subsequent screens.

Outcomes

Breast cancer is the most common cancer diagnosed in Australian women.

In 2020, 10,921 new cases of invasive breast cancer were diagnosed in women aged 50–74, equivalent to 307 new cases per 100,000 women in the population.

In the years before BreastScreen Australia began in 1991, incidence rose from around 180 new cases per 100,000 women aged 50–74 in 1982 to around 220 in 1990. Incidence thereafter rose from 240 new cases in 1991 to around 300 new cases per 100,000 aged 50–74 in 2000, where it remained until the years 2013 to 2019 during which it was around 320 new cases per 100,000 women. Incidence then decreased to 300 new cases per 100,000 women aged 50–74 in 2020.

Breast cancer is the second most common cause of cancer‑related death in Australian women, behind lung cancer. In 2022, 1,404 women aged 50–74 died from breast cancer, equivalent to 38 deaths per 100,000 women in the population.

Breast cancer mortality has decreased since BreastScreen Australia began – from 74 deaths per 100,000 women aged 50–74 in 1991 to around 40 deaths per 100,000 since 2014.

Aboriginal and Torres Strait Islander women

BreastScreen Australia outcomes are reported for Aboriginal and Torres Strait Islander participants for the performance indicators participation, incidence, and mortality.

Over the 2 years 2021–2022, around 28,000 Aboriginal and Torres Strait Islander participants aged 50–74 were screened through BreastScreen Australia – 37% of Aboriginal and Torres Strait Islander women in the target population.

After adjusting for age, participation was 25% lower for Aboriginal and Torres Strait Islander women than for non-Indigenous women.

In 2016–2020, 818 Aboriginal and Torres Strait Islander women aged 50–74 were diagnosed with breast cancer. After adjusting for age, incidence was 7% lower for Aboriginal and Torres Strait Islander women than for non-Indigenous women.

In 2018–2022, 154 Aboriginal and Torres Strait Islander women aged 50–74 died from breast cancer. After adjusting for age, mortality was 37% higher for Aboriginal and Torres Strait Islander women than for non-Indigenous women.
 

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