Roll-out of breastscreening programme extension
1 July 2004 Media Statement
Roll-out of breastscreening programme extension
The BreastScreen Aotearoa programme will be extended to include younger and older women for regular two-yearly screens, Health Minister Annette King says.
“The programme already provides more than 100,000 mammograms each year to women aged 50 to 64. From today, women aged between 45 and 69 will be eligible to join the programme, and over the next few years, this extension to the programme will effectively double the size of BreastScreen Aotearoa.”
Ms King said that breast screening programme service providers had shown great commitment to the programme, and had worked hard since she announced the extension in February to ensure that the necessary capacity is available to screen the extra women. “The overall aim is to be able to screen women new to the programme as soon as possible while maintaining the programme’s high quality. Initiatives to build capacity include efforts to recruit and train new staff to meet existing and future demand.
"Since February 2004, an expert advisory group has met twice to advise on a detailed implementation plan. Their advice is that priority should be given to women who have been previously screened in the programme, and they also advise that there should be two-yearly screening for all women involved in the programme. Women newly eligible to join the programme should be invited for their two-yearly screen as soon as capacity allows.
"The expert advisory group recommended that screening for women aged 45 to 49 not commence until 1 July 2005, but, after advice from the Ministry of Health, I have agreed that women in this age group should be offered screening as soon as capacity is available", Ms King said. "All women aged 45 and up to their 70th birthday, who have not been screened within the past two years, can register through the call centre (0800 270 200) and will receive a screening appointment from the provider in their region as soon as capacity is available."
Ms King said substantial planning and infrastructure is required for a successful programme. Laying the original foundations of the programme took three years, before BSA started nationwide, and women were invited to be screened in late 1998, she said.
"In addition, once screening started then, it was some time before all women in the eligible age group were able to receive their first screening mammogram. The same situation applies with this extension to the programme, which is making publicly funded screening mammography available to over 200,000 more New Zealand women. It will take some time to screen all these additional women.
"The programme will nearly double over the next four years. While women may have to wait for their first appointment, once they are in the programme they will receive regular two-yearly mammograms while they are still eligible," she said.
“As capacity is built, more women will be screened. The programme has set provisional targets for the increases, with these targets to be reviewed after three months and monitored monthly after that.
"The targets start with an extra 2850 screens for the first three months ending 30 September 2004, increasing to 3000 per month by June 2005. This represents about 22,000 extra women screened in the first year. In the following year the number of extra women screened will increase to around 66,000. It is estimated the extension will cost $13.2 million in the first year."
Ms King said the extra screens are additional to the 9642 women currently screened each month in the programme. "We also must ensure health services can treat women where necessary, that any increased capacity in screening and assessment services matches increased treatment capacity. The Ministry of Health will work closely with District Health Boards to help develop this capacity.
“Early detection through regular mammograms offers the best chance of successful treatment, and women of any age should be aware that if they have suspicious signs or symptoms of breast disease, have previously been treated for breast cancer, or have a close family history of breast cancer, they already qualify for publicly-funded mammograms with a referral from their GP to a DHB breast diagnostic service. These services are provided outside the programme.
"It is most important that all women remember that whether they are participating in the programme or not, if they have any concerns or symptoms, they should discuss these with their GP."
Ms King says work is also continuing on the logistics of expanding the use of the BSA mobile mammography services to include women at high risk of developing breast cancer, and women who are unable to access a fixed mammography site.
The current screening interval for women in the programme is two yearly. Some countries, such as the United Kingdom, screen three yearly and others, such as Japan and the United States, screen more frequently, but many others screen two yearly as the best way of balancing the benefits and potential harms of screening. The expert advisory group also considered carefully the frequency with which women aged 45-49 should be screened, as there is evidence that although breast cancer is more difficult to diagnose in this group, and the incidence is less, in a significant proportion of younger women the cancer is more aggressive. The group recommended that all women should be screened every two years based on the available evidence and taking into consideration the rate at which capacity can be increased in the programme. This is the same as the current screening interval for women aged 50 to 64.
the programme and maintaining quality:
In order to maintain the high quality of the programme, women 50 to 69 who have been previously screened within BSA will be recalled as soon as their next mammogram is due, and then previously unscreened women in the 50 to 64 age group, who register with the programme, will receive appointments as these become available. All other women in the eligible age range who register with the programme will receive an appointment as soon as capacity in their region allows.
Screening for women who have been treated for breast
Women in the eligible age range who have been treated for breast cancer previously require more regular follow-up under the supervision of their doctor, and receive publicly-funded mammograms, if indicated, with a doctor’s referral. They are able to rejoin the programme five years after the cancer was diagnosed.
Support for the
New Zealand women have shown strong support for BreastScreen Aotearoa since it began six years ago in December 1998. In the two years to December 2003 more than 62 per cent of eligible women have had mammograms through BreastScreen Aotearoa. During the same period 1200 cancers have been detected through the programme. Since the programme commenced through to December last year (2003) 2926 cancers have been detected.
Women aged 45 to 69 are encouraged to ring the BreastScreen Aotearoa free phone line - 0800 270 200 – for further information about the programme, to find out what's involved in registering in BreastScreen Aotearoa, or for details of availability of screening services in their area.