BreastScreen Australia monitoring report 2025

Indigenous status of women who participate in BreastScreen Australia is self‑reported by women at the time of their screen.

In 2022–2023, a total of 38,073 Aboriginal and Torres Strait Islander participants aged 40 and over were screened through BreastScreen Australia. Of these, 31,329 (82.3%) were aged 50–74, which equates to a crude participation rate of 35.9% (Table 10.1).

After adjusting for age, the participation rate of Aboriginal and Torres Strait Islander women aged 50–74 in BreastScreen Australia was 30% lower than for non-Indigenous women (36.1%, compared with the non‑Indigenous rate of 51.2%) (Figure 10.1).

Participation for 2022–2023 uses population based on the 2021 Census for the first time. This is important because the Indigenous population in the 2021 Census was 25.2% higher than the estimated population in the previous 2016 Census (see Box 10.2), which has the effect of lowering the overall participation of Aboriginal and Torres Strait Islander women compared to previous years.

Trends for participation of Aboriginal and Torres Strait Islander women have been recalculated back to 2016–2017 with populations based on the 2021 Census. 

In these recalculated trends, the crude participation rate of Aboriginal and Torres Strait Islander women aged 50–74 increased from 32.4% in 2016–2017 to 34.2% in 2018–2019 before decreasing to a low of 31.3% in 2020–2021 due to the impact of the COVID-19 pandemic from March 2020. Participation thereafter increased to 35.9% in 2022–2023.

From these trends it is apparent that Aboriginal and Torres Strait Islander women have always had a lower participation rate than non-Indigenous women (Figure 10.2).

The lower participation rate of Aboriginal and Torres Strait Islander women may reflect a decreased opportunity to screen compared with non‑Indigenous women. There may also be a level of under‑reporting of Indigenous status in BreastScreen data (as Indigenous status is self‑reported by participants at the time of their screen), which would also have the effect of lowering the participation rate.

Results of a recent Queensland project, ‘Closing the Gap in Breast Cancer Screening’, suggest that different screening behaviour of Indigenous women may play a significant role in their lower participation rates. This project aimed to address barriers to screening for Aboriginal and Torres Strait Islander women through culturally appropriate messages, art shows and partnerships with local Indigenous groups, in order to build trust, educate and support Indigenous women to attend BreastScreen Australia. The project reported an increase in Aboriginal and Torres Strait Islander participation in Queensland from 49% to 56% in 2 years.

Initiatives such as these are common to state and territory BreastScreen programs. These strategies and initiatives are designed to be culturally sensitive and appropriate to the knowledge, attitudes and beliefs of Aboriginal and Torres Strait Islander women. They include dedicated and appropriate communication resources, group bookings for Indigenous women who would prefer to attend as a group, and the use of Indigenous artwork. BreastScreen workers liaise closely with Aboriginal Health Workers and Aboriginal and Torres Strait Islander community groups to increase the acceptance of screening.

Access to BreastScreen services can also be a barrier to participation in BreastScreen by Aboriginal and Torres Strait Islander women. This is particularly true for women living in Very remote areas. AIHW’s interactive Access to BreastScreen Australia screening services dashboard shows the minimum time it takes women aged 50–74 from the general and Aboriginal and Torres Strait Islander populations to drive to a BreastScreen Australia screening service (AIHW 2024a). These data show that 26% of Aboriginal and Torres Strait Islander women aged 50–74 living in Very remote areas live over a 2-hour drive from a BreastScreen service that is open at least every 2 years (AIHW 2024a), which can limit access to services for these women.