BreastScreen Victoria (Australia)

Overview of BreastScreen Program

Nikki McGrath, Health Promotion Manager

September 2014

Topics covered

• Background on Population Health Screening

• BreastScreen Australia

• BreastScreen Victoria Program

Where can women screen

Eligibility

Results

Population screening…

Set criteria by World Health Organisation with a principle that ‘programs do more good than harm’ at a reasonable cost.

Geneva Switzerland

World Health Organisation Principles

• Aim to increase detection and reduce the impact of disease by testing a healthy population

• There must be a good chance that subsequent treatment can increase survival from the disease

• Australia uses modified WHO principles to guide screening programs

• Acceptable screening test repeated at intervals

Population based Australian cancer screening programs www.cancerscreening.gov.au

Evidence for a population screening program for breast cancer

• Studies and randomised controlled trials over 20 years in 4 countries

• First mammography programs 1987 - Iceland and Sweden

• Now standard in many western countries - U.S.A, Canada, U.K., Israel, France, Germany and Switzerland.

BreastScreen Australia – a population screening program for breast cancer

• BreastScreen Australia established 1991

• Joint funding state/territory and Commonwealth

• State/territory implementation, local services manage

• National Accreditation Standards

BreastScreen Australia

GoalTo reduce breastcancer mortalityby 30% throughearly detection

AimTo screen 70% of women in the 50 to 74 age group

Why do we do this?

New cases and deaths in 2011 for cancers in Victorian women

3499

Victorian Cancer Registry 2012

3748

1713

956

336698 765

2360

1,000

2,000

3,000

4,000

Breast Bowel Lung Ovary

New

cas

es/d

eath

s in

201

1

Type of Cancer

New cases

Deaths

616

Victorian Cancer Registry 2012

BreastScreen Victoria – The facts

• Free breast cancer screening program

• Asymptomatic women aged between 50-74

• GP referral not required

• Female radiographers

* In May 2013 the Commonwealth Government announced an extension to the target age range to 50-74. This

will be a staggered roll-out over the next 3 years

Recommendations for breast screening

• Communication strategies target 50-74 year olds

• All women over 40 are eligible

• Recommended every 2 years

• Complements Breast Awareness

BreastScreen Victoria program

Why women aged 50 to 74?

• Evidence shows breast screening reduces the most deaths in this age group

• Mammograms are the most effective screening method for finding early breast cancer in this age group

• Women in 40s and over are 74 still at risk

2008 age specific incidence and mortality

23

156

606

903

840

455425

20

74130

155 134

217

20

100

200

300

400

500

600

700

800

900

Under 30 30-39 40-49 50-59 60-69 70-79 Over 80

Age group at diagnosis / death

New

cas

es /

deat

hs in

200

8

New casesDeaths

Victorian Cancer Registry 2012

Pre/post menopause breast tissue

woman in her 40spost-menopausal woman

BSV Results- 11/12 financial year

• 204,279 women screened

• 83% women were aged between 50-69 years

• 84% women returning for 2nd + screen

• 996 invasive cancers and 308 DCIS diagnosed

• 608 invasive cancers were 15mm or less

Benefits of BreastScreen

• Regular screening prevents deaths from breast cancer

• Breast screens can detect majority of cancers early – even

before they can be felt or noticed.

• If breast cancer is found early, it is more likely to be small,

and successfully treated

• The earlier breast cancer is found, the better your chance

of surviving it

Limitations of BreastScreen

• Anxiety

• Over – treatment:

• Some women may be diagnosed with breast cancer that would not develop into a life-threatening cancer, therefore, some women may receive treatment that might not have been necessary.

• Exposure to radiation • Modern mammography machines use the smallest amount of radiation

possible while still getting a high quality X-ray picture. The radiation from screening (which involves two X-rays of each breast) is about the same as 18 weeks of exposure to natural radiation in the environment.

For more information or to make an

appointment visit

breastscreen.org.au

Or call 13 20 50

Useful references…

• Wilson JMG and Junger G (1968), Principles and practice of screening for disease. WHO Public Health Paper 34, WHO, Geneva.

• Breast cancer screening in Australia: future directions (1990) AGPS, Canberra.

• Breast Cancer Screening (2002) IARC Handbooks of Cancer Prevention. IARC Press.

• National Breast and Ovarian Cancer Centre. Breast cancer risk factors: a review of the evidence. National Breast and Ovarian Cancer Centre, Surrey Hills, NSW, 2009

• www.breastscreen.org.au