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.
How many people participated?
The most recent complete participation data are for participants who had a screening mammogram in the years 2022 and 2023, with preliminary data for the years 2023 and 2024.
Over the 2 years 2023–2024, more than 1.9 million participants aged 50–74 were screened through BreastScreen Australia – 52% of the target population. This was similar to the more than 1.9 million who screened over the 2 years 2022–2023, which was 52% of the target population, and 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, 51% in 2022–2023, and to 52% in 2023–2024.
The proportion of participants aged 50–72 who rescreened within 27 months was 54% after having their first screen through BreastScreen Australia in 2021, 63% after their second screen in 2021, and 78% after having their third or higher screen in 2021. Similar to participation, rescreening has also decreased due to the impact of the COVID-19 pandemic, although with rescreening after screens that occurred in 2021being higher than rescreening after screens that occurred in 2020.
Screening results in 2023
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 2023, 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 2022, albeit with a slight decrease.
Breast cancers detected in 2023
BreastScreen Australia aims to maximise the detection of invasive breast cancers, particularly small cancers, to achieve the desired reductions in morbidity and mortality.
In 2023, 6,410 participants aged 50–74 had an invasive breast cancer detected through BreastScreen Australia. Invasive breast cancer detection rates in 2023 for participants aged 50–74 were:
- 99 per 10,000 participants screened for the first time
- 59 per 10,000 participants attending a subsequent screen.
Invasive breast cancer detection is higher for participants 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 2023, 3,705 participants aged 50–74 had a small (≤15 mm) invasive breast cancer detected through BreastScreen Australia. This was equivalent to 45% of invasive breast cancers detected in participants attending their first screen, and 61% of invasive breast cancers detected in those attending subsequent screens.
Cancer and death outcomes
Breast cancer is the most common cancer diagnosed in Australian women.
In 2021, 11,540 new cases of invasive breast cancer were diagnosed in women aged 50–74, equivalent to 320 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, before increasing to 310 new cases per 100,000 women in 2021.
Breast cancer is the second most common cause of cancer related death in Australian women, behind lung cancer. In 2023, 1,446 women aged 50–74 died from breast cancer, equivalent to 39 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 37 deaths per 100,000 in 2023 (age-standardised).
Aboriginal and Torres Strait Islander women
BreastScreen Australia outcomes are reported for Aboriginal and Torres Strait Islander women for the performance indicators participation, incidence, and mortality.
Over the 2 years 2022–2023, around 31,000 Aboriginal and Torres Strait Islander participants aged 50–74 were screened through BreastScreen Australia – 36% of Aboriginal and Torres Strait Islander women in the target population.
After adjusting for age, participation was 30% lower for Aboriginal and Torres Strait Islander women than for non-Indigenous women.
In 2017–2021, 820 Aboriginal and Torres Strait Islander women aged 50–74 were diagnosed with breast cancer. After adjusting for age, incidence was 19% lower for Aboriginal and Torres Strait Islander women than for non-Indigenous women.
In 2019–2023, 160 Aboriginal and Torres Strait Islander women aged 50–74 died from breast cancer. After adjusting for age, mortality was 26% higher for Aboriginal and Torres Strait Islander women than for non-Indigenous women.
Since BreastScreen Australia began
BreastScreen Australia was established in 1991 as the National Program for the Early Detection of Breast Cancer, with national data reported from 1996 onwards. The number of screening mammograms performed, and invasive breast cancers detected by BreastScreen Australia, has been calculated over the years 1991 to 2023, using estimates from 1991 prior to data collection.
Since the program began, it is estimated that BreastScreen Australia has performed more than 26.7 million screening mammograms, and detected over 137,000 invasive breast cancers.
The AIHW has previously conducted data linkage studies of women diagnosed with breast cancer between 2002 and 2012. These studies showed that breast cancers detected through BreastScreen Australia had a 54% to 63% lower risk of causing death than breast cancers diagnosed in women who had never screened through BreastScreen Australia. These findings demonstrate the benefits of breast cancer screening in Australia (AIHW 2018a, 2018b).