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Thousands forego vital cancer screen

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Thousands of breast cancers are going undetected because more than a million women each year fail to have a mammogram.

Breast screening figures released by the Australian Institute of Health and Welfare show that 45 per cent of women aged between 50 and 69 years did not have a free mammogram in 2010-11, meaning that potentially more than 3000 breast cancers went undetected.

Though many women, particularly those who live in remote areas, are Aboriginal or Torres Strait Islander, or do not speak English as a first language, still are not being regularly screened, the program has nonetheless saved thousands of lives through the early detection of the deadly cancer.

All up, 1.3 million women – 55 per cent of the target 50 to 69 year age group – were screened for breast cancer in 2010-11, and the disease was detected in around 290 of every 100,000 people examined.

Significantly, screening has proven to be effective at detecting breast cancer at an early stage of development, when treatment is likely to be most effective.

The Institute found that in half of all cases where cancer was detected in women being screened for the first time, it was small (less than 15 millimetres in diameter), and among those with cancer being screened a second time or more, the detection rate was even higher – 63 per cent.

The significance of early detection is that it greatly increases the likelihood of effective treatment and survival.

According to the report, BreastScreen Australia Monitoring Report 2010-11, 61 per cent of breast cancers detected by the program are small, compared with less than 30 per cent of those diagnosed in other circumstances.

The success of the program has been underlined by figures showing that, since free breast screening was introduced in 1991, the breast cancer mortality rate has fallen from 68 per 100,000 women to 43 per 100,000.

“This has been largely attributed to the early detection of cancers through screening practise, along with advances in management and treatment,” the Institute said.

Despite advances in detection and treatment, breast cancer still claims hundreds of lives every year. In 2010, 1098 women aged between 50 and 69 years died from breast cancer, making it the second-most common cause of cancer-related death after lung cancer.

Public health experts have expressed particular concern about the relatively low rates of breast cancer screening among Aboriginal and Torres Strait Islander women. In 2010-11, just 36 per cent of Indigenous women in the target age group had a mammogram, compared with 54 per cent of those from other backgrounds.

A booklet designed to help inform and support Indigenous women about breast cancer, including its detection, treatment and follow-up care, was last week launched by Health Minister Peter Dutton.

Mr Dutton said breast cancer was the most commonly diagnosed cancer among Indigenous women, and they currently faced significantly worse survival prospects compared with the broader community.

“Between 2006 and 2010, Aboriginal and Torres Strait Islander women had lower five-year crude survival for breast cancer than non-Indigenous women – 69 per cent and 83 per cent respectively,” the Minister said.

He said the booklet My Breast Cancer Journey: a guide for Aboriginal and Torres Strait Islander women, had been developed by Cancer Australia with funding from the Commonwealth to help improve those odds.

Adrian Rollins