Cancer screening and COVID-19 in Australia

At the time of publication, the COVID-19 pandemic continues to be an evolving situation, posing a threat to people’s health and wellbeing in Australia and globally. The data presented here cover the period from January to September 2020, capturing the first 9 months of the disease in Australia.

Data after this period will be captured in quarterly cancer screening data that are routinely published by the AIHW.

The national data included in this report, as well as state and territory monthly data, are shown in the associated data tables.

To protect clients, staff and the community from the risk of COVID-19, BreastScreen services were temporarily suspended from 25 March 2020. While the suspension was lifted around a month later (in late April–early May 2020 for many services), breast screening resumed in a staged approach with longer appointments and precautionary measures to ensure the safety of women and staff. The rate at which BreastScreen services could resume was impacted by various jurisdictional social distancing and infection control guidelines and requirements. BreastScreen services remained open during Victoria's second wave.

The number of screening mammograms performed through BreastScreen Australia significantly declined in March 2020 as the COVID-19 pandemic worsened and tighter restrictions were put in place that included a suspension of all BreastScreen services from 25 March 2020.

While more than 70,000 screening mammograms were conducted in March 2020, this had fallen to just over 1,100 in April. By comparison, in April 2018, more than 74,000 screening mammograms were carried out (2018 is chosen as the comparison year instead of 2019, as BreastScreen Australia is a biennial program).

Following an easing of restrictions that included a lifting of the suspension from late April/early May 2020, the number of screening mammograms increased through May and June, and in July 2020 numbered around 3,000 more than in July 2018. In September, the number of screening mammograms increased to over 90,000, which was again greater than the number of screening mammograms in September 2018.

In summary, while there were around 145,000 fewer screening mammograms performed through BreastScreen Australia in January to June 2020 compared with January to June 2018, there were around 12,000 more screening mammograms performed through BreastScreen Australia in July to September 2020 compared with July to September 2018.

Notes:

1. As screening through BreastScreen is biennial, 2020 data are compared to 2018 data (not 2019 data).
2. Data show the number of screening mammograms performed in each fortnight. Date on x axis corresponds to the first date of the fortnight in 2020.
3. Shading labelled ‘a.’ refers to the period of tightened restrictions during Australia’s ‘first wave’; shading labelled ‘b.’ refers to the period of tightened restrictions in Victoria during the ‘second wave’.
4. Data were extracted from state and territory BreastScreen registers and provided to the AIHW in November 2020. Data in this report are considered preliminary, and may differ from data sourced at a different time.

Chart: Australian Institute of Health and Welfare

Source: Australian Institute of Health and Welfare analysis of state and territory BreastScreen register data

Data show a decline in the number of cervical screening tests from the second half of March 2020. The number of tests remained low throughout April, during which there were fewer than 30,000 cervical screening tests carried out. The number of cervical screening tests increased in May and June, with a slight decrease in July and August, before increasing again in September 2020. Even with these differences, the number of cervical screening tests appear to have levelled off in July to September 2020.

While there were fewer cervical screening tests in 2020 compared with 2019, the impact of COVID-19 cannot be quantified without further years of data (as 2020 is the first year impacted by the transition to 5-yearly screening).

Notes:

1. The number of tests conducted was expected to be lower in 2020 than in 2019, irrespective of the COVID-19 pandemic and subsequent restrictions due to a change from 2-yearly to 5-yearly screens.
2. Data show the number of cervical screening tests performed in each fortnight. Date on x axis corresponds to the first date of the fortnight in 2020.
3. Shading labelled ‘a.’ refers to the period of tightened restrictions during Australia’s ‘first wave’; shading labelled ‘b.’ refers to the period of tightened restrictions in Victoria during the ‘second wave’.
4. Data were extracted from the National Cancer Screening Register in November 2020. Data in this report are considered preliminary, and may differ from data sourced at a different time.

Chart: Australian Institute of Health and Welfare

Source: Australian Institute of Health and Welfare analysis of National Cancer Screening Register data

References

Smith, MA, Gertig, D, Hall, M, Simms, K, Lew, JB, Malloy, M, Saville, M, & Canfell, K 2016. Transitioning from cytology-based screening to HPV-based screening at longer intervals: implications for resource use. BMC health services research, 16, 147.

Notes:

1. Data show the number of iFOBT kits performed in each fortnight (vertical bars) and the number of invitations sent each fortnight (line). Date on x axis corresponds to the first date of the fortnight in 2020.
2. Shading labelled ‘a.’ refers to the period of tightened restrictions during Australia’s ‘first wave’; shading labelled ‘b.’ refers to the period of tightened restrictions in Victoria during the ‘second wave’.
3. Data were extracted from the National Cancer Screening Register in November 2020. Data in this report are considered preliminary, and may differ from data sourced at a different time.

Chart: Australian Institute of Health and Welfare

Source: Australian Institute of Health and Welfare analysis of National Cancer Screening Register data