Boosting breast cancer screening rates in Melbourne’s north and west

Breast cancer screening
  5 December 2023  Dr Jeannie Knapp – NWMPHN GP clinical advisor   

What’s the problem?

In September this year, the Australian Institute of Health and Welfare (AIHW) published its annual Breastscreen Australia monitoring report, providing insights into breast cancer screening. The report included participation rates up to 2019 for different regions, categorised by primary health network, plus statewide data for Victoria in 2020-2021 and 2021-. Combined with other AIHW cancer screening data, this picture emerges:

2014-2015 2015-2016 2016-2017 2017-2018 2018-2019 2019-2020 2020-2021 (Vic) 2021-2022 (Vic)
State/territory PHN name Participation (%) Participation (%) Participation (%) Participation (%) Participation (%) Participation (%) Participation (%) Participation (%)
Vic North Western Melbourne 51.2 51.7 51.6 51.6 50.0 41.2 45.5 50.6

From AIHW – cancer screening programs quarterly data

The data shows a significant decrease in breast screen participation rates in 2019-2020, dropping from 50 to 41.2 per cent for women aged 50 to 74. There is no data specific to North Western Melbourne Primary Health Network (NWMPHN) for the subsequent 2 years, but statewide there seems to have been a recovery in 2021-2022 to pre-pandemic rates.

However, these “baseline” levels are still inadequate. In contrast, cervical screening participation was 60.6 per cent in NWMPHN between 2018 and 2021. This was  prior to introduction of self-collected screening, which is expected to deliver a further .

Breast cancer remains the most common cancer, and most common cause of cancer-related deaths, in women in Australia. In 2019, 50 per cent of all cancers in women aged 50 to 74 were detected through breast screening. In 2021-2022, the average breast screening participation rate across Australia has built back to 50 per cent. However among Aboriginal and Torres Strait Islander women it is much lower, coming in at 35 per cent.

Who qualifies for breast screening?

Through the BreastScreen Australia Program, BreastScreen Victoria provides free mammograms every 2 years to women and trans or gender diverse (TGD) people who are:

  • living in Victoria
  • asymptomatic
  • aged 50 to 74.

People aged 40 to 49, or over 75, are also eligible for screening, but should discuss their individual risk factors with their doctor first. They will not  be sent routine reminders.

Any patient with symptoms of breast cancer should be referred for diagnostic breast .

What can general practices do to increase participation rates?

Unlike the National Cervical Screening Program, which sits mostly within general practice from recruitment through to performing screening and referrals, the BreastScreen Australia Program is population-based, using the electoral roll for recruitment, and exists as a stand-alone service.

However, there is still much we can do to encourage women and TGD people to have a routine breast screen.

General practices can consider these strategies:

  • Discuss breast screening, including the benefits of mammograms, the need to screen every 2 years and what breast cancer symptoms to be aware of, with all eligible patients.
  • Use your clinical reminder system to proactively identify patients due for a breast screen.
  • Identity eligible patients using the Pen Clinical Audit Tool and invite them to enroll with BreastScreen.
  • Include discussion of breast screening in health assessments for people aged 45 to 49.
  • Offer educational resources in multiple languages.
  • Complete our quality improvement (QI) activity to identify eligible patients aged 50 to 74 for breast screening.

More information