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Screening success as death rates fall


Breast cancer deaths have fallen by a third since the national screening program was rolled out more than 20 years ago.

While little more than half of women in the target age group of between 50 and 69 years have a mammogram in any one year, Australian Institute of Health and Welfare figures indicate the BreastScreen Australia program has been effective in the early detection of breast cancers, vastly improving the prognosis of those found to have a tumour.

Almost half of breast cancers detected in the initial round of screening in 2011 and 2012 were classified as small (less than 15 millimetres in diameter), as were 61 per cent of those found in subsequent screens.

By detecting the cancers early, the screening program gives women with breast cancer access to wider and better treatment options and greater chances of survival.

This is significant given the relative prevalence of breast cancer – it is the most common type affecting women, with around 7500 new cases diagnosed among women in the 50 to 69 years age group in 2010.

While screening is just one element in the improved survival rate of people with breast cancer, the AIHW noted that since the BreastScreen Australia program began in 1991, breast cancer deaths in the target 50 to 69 years age group had dropped from 68 per 100,000 women to 44 – a 35 per cent fall.

Participation in the breast screening program has held steady for the last seven years at around 55 per cent of women in the target age group, but is lower in remote areas (46 per cent) and among Indigenous women (38 per cent).

A separate study by Breast Cancer Network Australia found that women diagnosed with breast cancer generally felt well served by their GP but experienced financial difficulty because of the costs associated with treatment.

A survey by the Network of 580 women with advanced breast cancer (that is, one that has spread from the breast to other parts of the body) found that 70 per cent believed their GP had a good or excellent knowledge of the issues associated with the disease that were most important to them, while almost 80 per cent reported their family doctor was almost always available when they needed them.

Underlining the lasting nature of the relationship most patients form with their GPs, 77 per cent of the women in the survey reported they had a regular doctor – including almost 60 per cent who said they had been seeing the same GP for more than five years.

“This survey has highlighted that GPs play an important and on-going role in the care of women living with secondary breast cancer,” the BCNA said. “The majority of survey respondents value the role of their GP and trust his or her judgement and clinical advice when it comes to their secondary breast cancer.

But the study also found that many such women were missing out opportunities for extra assistance in managing the effects of their disease.

It showed that only about one in five of women with advanced breast cancer did not have a current GP Management Plan, which would entitle them for up to five subsidised visits to allied health professionals each year, and less than 15 per cent had a GP Mental Health Care Plan, which provides for up to 10 subsidised visits to a counsellor, psychologist or specially trained social worker.

Network Chief Executive Officer Maxine Morand said GP Management Plans should be offered to women with advanced breast cancer as a matter of course.

“We know GP Management Plans really help women living with advanced disease to manage the ongoing side-effects of their treatment and care, and could also help with the significant financial challenges reported by survey respondents,” she said.

Ms Morand said almost two-thirds of those diagnosed with advanced breast cancer reported being in financial difficulty, with out-of-pocket expenses reaching an average of $687 a month.

Adrian Rollins