Australian Institute of Health and Welfare (2022) Cancer screening, AIHW, Australian Government, accessed 08 December 2022.
Australian Institute of Health and Welfare. (2022). Cancer screening. Retrieved from https://www.aihw.gov.au/reports/australias-health/cancer-screening-and-treatment
Cancer screening. Australian Institute of Health and Welfare, 01 December 2022, https://www.aihw.gov.au/reports/australias-health/cancer-screening-and-treatment
Australian Institute of Health and Welfare. Cancer screening [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2022 Dec. 8]. Available from: https://www.aihw.gov.au/reports/australias-health/cancer-screening-and-treatment
Australian Institute of Health and Welfare (AIHW) 2022, Cancer screening, viewed 8 December 2022, https://www.aihw.gov.au/reports/australias-health/cancer-screening-and-treatment
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Cancer is a major cause of illness and death in Australia – there are 1.2 million people alive in Australia who are either living with or have lived with cancer (AIHW 2022b). Latest data (2014–2018) 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 2022b).
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. See Cancer for information on cancer incidence, mortality, prevalence and survival.
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 screening in this section refers to the primary breast screening undertaken through BreastScreen Australia only.
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.
Over the 2 years 2020–2021, 1.7 million women aged 50–74 participated in BreastScreen Australia – almost 48% of the target population (AIHW 2022a, 2022c).
In 2020, almost 5,000 women aged 50–74 had an invasive cancer detected through BreastScreen Australia and 60% of those breast cancers were small (≤15 mm). Small breast cancers are associated with more treatment options and improved survival (AIHW 2022a).
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’ in this section.
All cervical screening is undertaken through the National Cervical Screening Program (NCSP).
From its commencement in 1991 to 30 November 2017, the NCSP targeted people aged 20–69 for a 2-yearly Papanicolaou smear, or ‘Pap test’ (see Glossary).
A renewed NCSP, introduced in December 2017, targets people aged 25–74 for a 5-yearly human papillomavirus (HPV) test. The cervical screening test detects the presence of cancer-causing HPV. If detected, a further examination of cells (cytology) is performed (see Glossary).
Until 5 years of data are available for the renewed NCSP, participation rates are estimated.
Over the 4 years 2018–2021, more than 4.2 million people aged 25–74 participated in cervical screening, which is an estimated 62% of the eligible population (AIHW 2022e).
Over the same period, 86,000 people who have ever identified as being of Aboriginal and Torres Strait Islander origin participated (AIHW 2022e) (see Glossary).
In 2018–2021, participation in cervical screening:
In 2021, for every 1,000 participants screened, 17 had a high-grade abnormality detected, providing an opportunity for treatment before possible progression to cervical cancer (AIHW 2022e). Participants aged 30–34 had the highest high-grade cervical abnormality detection rate (25 per 1,000) (AIHW 2022e).
Bowel cancer screening in this section refers to the screening managed by the National Bowel Cancer Screening Program (NBCSP).
The NBCSP was established in 2006, offering screening 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.
In 2019–2020 the program invited men and women turning 50, 52, 54, 56, 58, 60, 62, 64, 66, 68, 70, 72 and 74 to screen for bowel cancer using a free immunochemical faecal occult blood test (iFOBT) (see Glossary).
Over the 2 years 2019–2020, of the 5.8 million people invited, 43.8% participated in the program (AIHW 2022d). Participation was higher for women than men (45.7% and 41.9%, respectively) (AIHW 2022d).
Since the expansion of the program from 2014, the NBCSP participation rate increased from 39% in 2014–2015 to 43.8% in 2019–2020 (AIHW 2022d). Participation in the NBCSP varied between population groups and across areas of Australia in 2019–2020:
In 2020, 7% of participants aged 50–74 who returned a valid kit had a positive iFOBT test (see Glossary). Of those with a positive result, 61.8% 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 2020:
Participants who identified as being Indigenous Australians, 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 2022d).
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).
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 a data linkage project that will examine adverse events after NBCSP-related colonoscopy; a data linkage project that will allow more complete monitoring of bowel and cervical screening programs as well as monitoring the impact of HPV vaccination; and another data linkage project that will provide more detailed analysis of breast screening behaviour and cancer outcomes, including among Aboriginal and Torres Strait Islander women.
The COVID-19 pandemic has affected many areas of people’s lives, including their access to, and use of, health services such as cancer screening programs. From the start of the COVID-19 pandemic in 2020 through to the first few months of 2022, many health care services suspended or changed the way they delivered services. The AIHW examined the impact of the COVID-19 pandemic on the number of cancer screening tests performed from January 2020 to September 2020 (AIHW 2021). The AIHW continues to monitor and publish quarterly the volume of activities for the 3 population-based screening programs:
BreastScreen Australia services were suspended from March 25th until late April or early May 2020 due to COVID-19 restrictions. After this time breast screening resumed in a staged approach, with longer appointments and precautionary measures to ensure the safety of women and staff. The COVID-19 pandemic and suspension of BreastScreen services had a clear impact on breast cancer screening, with fewer screening mammograms performed through BreastScreen Australia between April and August 2020 than the same period in 2018 (the latest comparable year) (AIHW 2021). From May 2020, the number of screening mammograms recovered progressively to pre-COVID-19 levels until June 2021 but fell again during the second half of 2021 (July to December 2021) coinciding with further COVID-19 restrictions (AIHW 2022c).
There was no suspension of the NCSP due to COVID-19 at any time during 2020. However, the Cervical Screening Test is usually carried out by a person’s general practitioner (GP). While GP services continued during the pandemic, there was an increased use of telehealth consultations, and cervical screening tests require in-person consultations. The impact of the COVID-19 pandemic on participation in the NCSP is unclear, but there is some indication that the number of screening HPV tests may have been reduced (AIHW 2021).
There was no suspension of the NBCSP at any time during 2020. Eligible people are invited to participate with an at-home test kit, and people must leave their homes to mail their completed test kit to a pathology laboratory. Due to inconsistent weekly invitation volumes over this period, it was not possible to determine what impact the COVID-19 pandemic had on the NBCSP between January and September 2020 (AIHW 2021).
To better understand the impact of COVID-19 on cancer screening, activity data needs to be considered in the context of COVID-19 social restrictions and interruptions to services, as well as broader program-specific factors. These factors include seasonal variation in screening, changes in program methodology, and changes to data sources.
The full impact of the COVID-19 pandemic on cancer incidence and mortality requires additional data sources and cannot be known until longer-term data are available.
For more information about how the pandemic impacted cancer screening, see ‘Chapter 2 Changes in the health of Australians during the COVID-19 period’ in Australia’s health 2022: data insights.
For more information on cancer screening, see:
Visit Cancer screening and Cancer for more on this topic.
AIHW (Australian Institute of Health and Welfare) (2018) Analysis of cancer outcomes and screening behaviour for national cancer screening programs in Australia, AIHW, Australian Government, accessed 25 February 2022.
AIHW (2021) Cancer screening and COVID-19 in Australia, AIHW, Australian Government, accessed 23 December 2021.
AIHW (2022a) BreastScreen Australia monitoring report 2022, AIHW, Australian Government, accessed 28 October 2022.
AIHW (2022b) Cancer data in Australia 2022, AIHW, Australian Government, accessed 28 October 2022.
AIHW (2022c) Cancer screening programs: quarterly data, AIHW, Australian Government, accessed 28 October 2022.
AIHW (2022d) National Bowel Cancer Screening Program monitoring report 2022, AIHW, Australian Government, accessed 28 October 2022.
AIHW (2022e) National Cervical Screening Program monitoring report 2022, AIHW, Australian Government, accessed 28 October 2022.
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