Performance indicator 3: Recall to assessment
Summary
In 2023, the crude recall to assessment rate for participants aged 50–74 was 10.6% for the first screening round and 3.8% for subsequent screening rounds.
Definition
The proportion of participants aged 50–74 screened in a given year who are recalled for assessment.
Rationale
Participants are recalled to assessment for further investigation if their screening mammogram is found to be suspicious for breast cancer. BreastScreen Australia aims to maximise the number of cancers detected while minimising the number of unnecessary investigations.
Guide to interpretation
Recall to assessment is disaggregated into first and subsequent screening rounds because a participant is more likely to be recalled to assessment the first time they visit a BreastScreen service than at subsequent visits. This is for 2 reasons: first, a participant is more likely to have an invasive breast cancer detected on their first visit and, second, with no previous images against which to compare the images from their first screening mammography, it is more difficult to distinguish between what is normal and what might be suspicious (BreastScreen WA 2008).
Changes to recall to assessment rates should be considered alongside corresponding invasive cancer detection rates, as a higher recall to assessment rate may be considered acceptable if it leads to higher breast cancer detection rates.
Recall to assessment data are reported as a percentage of participants screened.
The most recent recall to assessment data are for participants screened in 2023.
More information on recall to assessment
A participant is recalled to assessment for mammographic reasons because their screening mammography images are found to be suspicious for breast cancer.
Assessment of participants recalled involves further investigation at the assessment centre.
This may include palpation, diagnostic mammography, ultrasound and, if required, a percutaneous biopsy (core biopsy of breast tissue for histological assessment or fine needle aspiration for cytological assessment).
Results
In 2023, of the 114,875 participants aged 50–74 who attended their first screening round, 12,177 were recalled to assessment, which equates to a crude rate of 10.6%.
Of the 897,394 participants aged 50–74 who attended subsequent screening rounds, 33,834 were recalled to assessment, which equates to a crude rate of 3.8%.
Recall to assessment trends
Between 2014 and 2023 the recall to assessment rate for participants aged 50–74 for the first screening round varied between 10.4% and 12.2%. Over the same period, the recall to assessment rate for subsequent screening rounds ranged between 3.5% and 4.0% (Figure 3.1).
Figure 3.1: Recall to assessment, participants aged 50–74, first and subsequent screening rounds, 2014 to 2023
This line chart shows this varied between 10.4% and 12.2% for the first screening round and between 3.5% and 4.0% for subsequent screening rounds.
| Years | First screening round | Subsequent screening round |
|---|---|---|
| 2014 | 12.2 | 4 |
| 2015 | 11.8 | 3.8 |
| 2016 | 11.3 | 3.7 |
| 2017 | 11.3 | 3.6 |
| 2018 | 11.2 | 3.5 |
| 2019 | 11.7 | 3.7 |
| 2020 | 11.4 | 3.8 |
| 2021 | 11.1 | 4 |
| 2022 | 10.6 | 3.9 |
| 2023 | 10.4 | 3.8 |
Source: AIHW analysis of BreastScreen Australia data. Data for this figure are available in tables A3.1a and A3.1b.
Recall assessment by age
In 2023, the proportion of participants attending their first screen who were recalled to assessment for further investigation was lowest for participants aged 40–44 at 8.8% and highest for participants 75 and over at 11.4% (Figure 3.2).
This pattern differed for participants attending subsequent screens; the proportion recalled to assessment was highest for participants aged 40–44 and 45–49 at 5.0% and 5.6%, followed by participants aged 50–54 and 75 and over at 4.4% and 4.5%. Participants aged 55–74 were least likely to be recalled after a subsequent screen, with recall rates ranging between 3.6% and 3.8% (Figure 3.2).
Figure 3.2: Recall to assessment, by age group, first and subsequent screening rounds, 2023
This line chart shows this was lowest for participants aged 40–44 for their first screen and participants aged 55–74 for their subsequent screens.
| Age group (years) | First screening round | Subsequent screening rounds |
|---|---|---|
| 40-44 | 8.8 | 5 |
| 45-49 | 10.1 | 5.6 |
| 50-54 | 10.8 | 4.4 |
| 55-59 | 10.2 | 3.6 |
| 60-64 | 10.3 | 3.6 |
| 65-69 | 10.2 | 3.7 |
| 70-74 | 10.4 | 3.8 |
| 75+ | 11.4 | 4.5 |
Source: AIHW analysis of BreastScreen Australia data. Data for this figure are available in tables A3.2a and A3.2b.
Recall assessment by state and territory
In 2023, the recall to assessment rates for participants aged 50–74 attending their first screen varied across the states and territories, from 8.7% to 12.0%. The corresponding rates for participants aged 50–74 attending subsequent screens varied from 3.2% to 4.5%.