BreastScreen program - deaths down, but early days yet

Breast cancer death rates in Australia have fallen since the introduction of the BreastScreen Australia Program in 1991, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

But it may be too early to draw conclusions yet, according to the Head of the AIHW's Health Registers and Cancer Monitoring Unit, Dr Paul Jelfs.

The report, BreastScreen Australia Achievement Report 1997 and 1998, was jointly produced by BreastScreen Australia, the AIHW and the Commonwealth Department of Health and Aged Care.

(The BreastScreen Australia Program provides free mammographic screening every two years to all women aged 40 or over, with women aged 50-69 years especially encouraged to attend. No referrals are required, and services are available throughout Australia.)

'The report shows that breast cancer death rates in the Program's target 50-69 year age group fell by 15% from 1991 to 1998', Dr Jelfs said.

'And from 1991 to 1997 breast cancer incidence rose by 21% in this age group.

'The rise in incidence rates is what we would expect in the early years of a cancer detection program. And we must bear in mind that the underlying breast cancer incidence rate was increasing before the BreastScreen Program began.

'That said, however, the quite sharp rise in incidence in the target 50-69 age group between 1992 and 1994 is at least partially attributable to the Program. We are seeing early detection in women who may otherwise have gone undetected for some years.

'Early detection, especially of small cancers (10 mm diameter or less) through mammographic screening, undoubtedly improves chances of surviving the disease.

'Nearly 3,000 breast cancers were detected through the Program in 1998, over 1,000 of which were small cancers.

'But improvements in treatment practices (surgery and chemotherapy) and disease management have also played a part in reducing death rates.

'It is very difficult to quantify the relative contributions-but BreastScreen Australia is commissioning a project to find out if it is possible to isolate the impact of early detection on breast cancer mortality.'

Participation in the Program is on the increase. In 1998, 1.3 million women were screened, including 54% of all women in the 50-69 target age group.

BreastScreen Australia says a 70% participation rate in the target group is needed to get significant mortality reductions. Work is under way to achieve this through recruitment campaigns.


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