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