U.K. and Australia Fight Breast Cancer with Free Screening for Women 50+

By Alice Alech, The Wip. Posted August 28, 2008.

Working as a breast screen radiographer or x-ray technologist can be rewarding and challenging at times but I know that detecting even a small breast cancer can make a difference in a woman's life. That's what makes it all worthwhile.

Breast cancer is the most common cancer in women worldwide, with one in nine women developing breast cancer malignancy at some stage in their lives. This is why Australia and the United Kingdom offer breast screening free of charge, providing programs that detect cancer at an early stage by offering mammograms (low dose x-rays can detect small changes in breast tissue which may indicate cancers too small to be felt by the woman or her doctor). These programs are funded by the government for a target age group of asymptomatic women, right through to the diagnosis. They have made a commitment to saving lives.

The National Health Service Breast Screening Program

The development of the United Kingdom program was based on a report produced by a working group chaired by Sir Patrick Forrest in 1985. The group investigated whether it would be efficacious to set up a mass screening, utilizing mammography as the screening tool for the early detection of breast cancer. They looked at evidence from several trials conducted overseas and compared it with the number of deaths from breast cancer in the U.K.

As a result of the Forrest report, the National Health Service Breast Screening Program (NHSBSP) was started in 1988 and achieved national coverage by the mid-1990s. Today there are 84 national screening centers in the United Kingdom.

The Australian Breast Screen Program

In 1987 statistics showed that breast cancer was by far the most common cause of death from cancer in Australian women. As a result, it was decided that an organized screening program be implemented. Randomized controlled trials were conducted, research from countries such as Sweden, Finland the Netherlands and the U.K. were studied, and in 1990 The Australian Breast Screen Program was launched. Health ministers responsible for the five states and two territories of Australia jointly agreed to fund the national mammography program. Today, there are 550 locations via fixed, relocatabe or mobile screening units in the country.

Both programs target women who are well and between 50 to 69 years (the U.K. provides screening up until 70 years), the age group that has the highest incidence of breast cancer.

Screening Outreach

Contacting women in the age group is the first step in both countries. In the United Kingdom, women who have reached the age of 50 and are registered with a general practitioner receive a letter inviting them for their first screen.

In Australia women are invited to call a toll free number which connects them directly to their nearest breast screen service where they are given an appointment for their first screen.

Once on the screening list, women receive letters every two years in Australia, and every three years in the U.K., inviting them to come in for their mammograms.

Younger women have less incidences of breast cancer and so are not included in the screening programs in either country. Pre-menopausal women also have dense breasts making it more difficult to detect abnormalities on the x-rays. With age, breasts become less dense and glandular, appearing clearer on the mammogram and thus allowing the film reader to make a more accurate diagnosis. Mammograms are most effective after the age of 50, when most women go through menopause. Some breast screen units in both Australia and the U.K. will, however, accept women aged 40, especially when there is strong family history of breast cancer. These women are so appreciative of the care they receive -- some have lost mothers, daughters, sisters, friends and many of them would not be able to pay for mammograms.

Each state and territory of Australia develops individually targeted messages to reach the general population. Similarly, each state does its utmost to reach the Aboriginal community through the group, Aboriginal Health Care Workers. This is not an easy task as language and cultural barriers do not make communication easy; interpreters are sometimes necessary.

Because of differing cultures among the indigenous population, outreach strategies vary from state to state; group bookings are often arranged along with transport and meals when the women have to travel great distances.

In 2005 I was part of a group that spent eight days x-raying women from the Aboriginal communities in South Australia. These women hardly ever venture out of their communities, so coming to us for screening required careful planning and coordination. They often arrived at the end of the day after traveling for hours so we greeted them with food and refreshments and tried to make them comfortable. An interpreter did most of the translating but we could easily see how relieved the women were to find an all-women team and we were thankful that most of those on our list had decided to come. It didn't matter that they turned up six hours late.

See more stories tagged with: health, breast cancer, mammography

Alice Alech is a qualified x-ray technologist and mammographer involved in the Breast Screen Program in both Australia and the U.K.

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