PBAC Outcomes by Meeting
Minister pays tribute to unsung heroes of women's cancer screening
Dr Wooldridge addresses the launch of two national reports by the Australian Institute for Health and Welfare (AIHW), Breast and cervical cancer screening in Australia 1996-1997 and Breast cancer survival in Australian women 1982-1994.
3 December 1998
Minister pays tribute to unsung heroes of women's cancer screening
Improved survival rates for women diagnosed with breast or cervical cancer have been welcomed by Federal Minister for Health and Aged Care, Dr Michael Wooldridge.
Dr Wooldridge was speaking at the launch of two national reports by the Australian Institute for Health and Welfare (AIHW), Breast and cervical cancer screening in Australia 1996-1997 and Breast cancer survival in Australian women 1982-1994.
"Deaths from cervical cancer fell by over one third, 34 per cent, between 1983 and 1996. Most of this decline is directly attributable to the national Pap smear cervical screening program," Dr Wooldridge said.
"In 1996 and 1997 over two and a half million Australian women were screened in Australia for cervical cancer.
"In 1997 alone, this lead to around 26,000 pre-cancerous abnormalities being detected, confirmed and managed - reflecting the aim of the Pap smear program to detect and treat cervical cancer even before it develops.
"Reported improvements in survival patterns of Australian women with breast cancer are also cause for hope, with the data showing women's relative survival proportion was 90.9 per cent 2 years after diagnosis.
"The reports show that breast cancer's impact in terms of both death and illness can be significantly reduced if the disease is detected at an early stage in its development.
"The AIHW report states that BreastScreen Australia is achieving high participation rates: in 1996 and 1997 over one and a quarter million Australian women were screened for breast cancer by BSA.
"In 1997 alone, Breast Screen Australia detected small invasive cancers in nearly 1000 women.
"In many cases, cancers detected through BreastScreen Australia would otherwise have become evident only much later and then, perhaps at a stage where the cancer was well advanced and less responsive to treatment.
"Significantly, the reports find there is very little difference in whether a woman was from an urban or rural area - both regions showed improved survival from breast cancer," he said.
Dr Wooldridge paid tribute to the thousands of women and men behind the success of Australia's breast cancer and cervical screening programs.
"These people are the unsung heroes of the emerging statistics which give us the hope that we are making a real difference in reducing deaths and illness from these cancers.
"The message of the AIHW reports couldn't be clearer - early detection is still the best, first line of defence against these cancers and that's why it is vitally important that Australian women make good use of our national screening programs - and have a free mammogram and a Pap smear, every two years," Dr Wooldridge said.
Free Pap smears are available from local doctors or health centres. Free mammograms are available at over 500 BreastScreen Australia locations around the country.
For information about Pap smear call 13 15 56 and BreastScreen Australia on 13 20 50.
The reports can be accessed via AIHW's web site at http://www.aihw.gov.au
- Summary of key statistics from the Reports
- Some of the stories behind the women's cancer screening programs
Attachment A Summary of key statistics from the Reports
- Breast cancer continues to be the most common cancer in Australian women. The lifetime risk of a woman developing breast cancer before age 75 years is 1 in 11.
- In 1996, 9,556 new cases of breast cancer were diagnosed in Australian women and 2,623 deaths were attributed to breast cancer in 1996.
- In the two years 1996 and 1997 over 1 and a quarter million [1,262,584] Australian women were screened for breast cancer.
- In 1997 alone, Breast Screen Australia detected small invasive cancers in nearly 1000  women.
- Women diagnosed with breast cancer from 1982-1994 showed a relative survival proportion of 90.9 per cent 2 years after diagnosis, 76.8 per cent 5 years after and 63.1 per cent 10 years after.
- There was very little difference in the 2 or 5 year relative survival proportions for women in urban and rural areas - and both improved over time.
- The lifetime risk of developing cancer of the cervix is one in 101.
- In 1996 and 97 well over 2 and a half million Australian women [2,619,273] were screened for cervical cancer.
- This lead to around 26,000 pre-cancerous abnormalities being detected, confirmed and managed, in 1997 alone.
- In 1995 cervical cancer was the 8th most frequently diagnosed new cancer. There were nearly 1000  new cases in Australian women in 1995.
- Cervical cancer is the 8th most common cause of cancer death in Australian women causing 302 deaths in 1996.
- Mortality rates for cervical cancer are declining - they fell by over a third [34 per cent] between 1983 and 1996 - almost all this decline is directly attributable to the National Cervical Screening Program.
- Pap smear screening has the potential to reduce squamous cervical cancer by up to 90 per cent.
Attachment B - Some of the stories behind the women's cancer screening programs
Our screening programs are constantly working to find ways to improve recruitment of hard to reach groups such as women from diverse cultural backgrounds.
In order to help women feel more at ease, ACT BreastSceen has found it is helpful to bulk-book groups of women of a similar language background. On one occasion about a dozen women of various ages from Chinese background were booked in for a breast screen followed by a Pap smear.
The oldest member of the group was an elderly Chinese lady who had never experienced either a mammography or a Pap smear.
The processes and their importance were carefully explained to her, and her screenings went very well. Afterwards she felt so positive about her good health initiative in having the screens that she decided to go out and buy two lottery tickets.
She later reported back to the screening unit that she was overjoyed at her "double happiness" - a common Chinese expression - not only had both her screens been normal, but both her lottery tickets had been winners.
It was considered that after her good fortune she would no doubt be an excellent advocate for screening in her community for many years to come.
QueenslandThis story dates back to earlier days when screening in rural and remote areas of Queensland was done by flying medical teams out to assess women in their communities.
In this instance an assessment team was flown from Townsville to the coastal town of Bowen to join up with a mobile unit. However on the approach to Bowen the planes landing gear didn't come down - and the passengers had a hair-raising bellyflop landing later describing the noise, dust and the sparks that flew from the gouged runway.
Yet despite their near death experience - the team's professionalism and commitment to the task at hand did not fail. The plane was now out of commission so the team got on with their assessment work and at the end of the day, organised a car and simply drove the 400 kilometres back up to Townsville.
It was all in a day's work …
NSWBreastScreen NSW has one service whose catchment area includes women living in the Great Dividing range. They tell a story of their first fateful time taking their mobile unit up the Dorrigo mountain - reputed to be the steepest descent in Australia.
Indeed the ascent was without incident and with all the women screened the unit headed back down the mountain.
They reckon it certainly lived up to its reputation when the 10 tonnes and 11 metres of BreastScreen bus terrified its driver by starting to career down that precipitous, twisting, winding mountain road.
All ended well - but the driver was later reported saying: "Next time a lady tells me how nervous she is about coming to BreastScreen - I might relate my story of how nerve-racking it can be for breastscreen to come to her!"
Northern TerritoryAlice Springs has a relocatable breast screen unit which travels up The Track [the Stuart Highway ] to Tennant Creek, Katherine and then by barge - a one week journey - to Nhullunbuy in Arnhem Land
The unit also has regular commitments to the Aborginal women who use the Alukura women's health centre outside Alice Springs.
On one visit to Tennant Creek, the radiographer was expecting a bus load of community women who had booked in for screening mammograms, when, to her horror, the machinery which loads the film for the mammograms broke. She delved into her toolbox and tried unsuccessfully to fix it herself.
In desperation she ran out to the local hospital and the handyman offered to come and check out the problem.
He assessed the situation and with a "no worries" headed off promising to return shortly. Turns out he went to the local car wreckers, found and dismantled an old carburettor and returned to the BreastScreen unit triumphant with a replacement part. It worked just fine!
In fact, to this day, the radiographer keeps the genuine replacement part she got from "down south" in her toolbox - because the repair was so good, the equipment has been working just fine ever since.
And - most importantly - none of the women who had turned up for their mammograms missed out.
South AustraliaWhen Breastscreen SA took their first visit to the Pitjantjatjara lands it was a very exciting event for everyone concerned. Breastscreen took a mobile screening service out Marla in the far north near the SA/NT border and screened 82 women in three and a half days!
The community women travelled to meet the mobile unit from across the Pitjantjatjara homelands and the BreastScreen team worked solidly to complete their work well before dusk each day so that the women could travel the long distances home without the added danger of wildlife and livestock on the roads.
Although there was a language barrier, staff spent much of the time laughing with the women. BreastScreen staff learnt a few words of Pitjantjatjara to aid communication and quite often an arm around a woman to position her for the x-ray was returned with a hug.
There was generally very little fear of the procedure and the relaxed atmosphere was infectious. Overall, a very successful visit, to be repeated in two years time, the recommended screening interval.
TasmaniaAnother story of our screening programs triumphing in spite of the elements comes from Tasmania where the breast screen unit was heading across the waters by barge to provide mammography to the women of King Island.
But when they got there an incoming storm had made the water levels so unexpectedly high that the barge was physically unable to dock.
Undeterred - the barge took refuge from the elements in Melbourne before returning after the storm to give the women of King Island their mammography screening.
VictoriaThis story is about a successful idea implemented to improve Pap smear screening of isolated underscreened women in rural Victoria. A series of outreach clinics targeting rurally isolated women in the western corner of Victoria has been an outstanding success.
A special word of mouth, grass roots advocacy system was put in place. Key women in the region were targeted to promote the importance of Pap smears in detecting and preventing cervical cancer. These included the owner of a general store, the local postie, a hairdresser and a range of other community contacts.
Since the program has been put in place these advocates have successfully spread the word about Pap smear - ensuring that all Pap test clinics have been fully booked.
Western AustraliaThe people of WA BreastScreen have become famous for delivering their mammography service to women in the face of a cyclone.
The story goes that several years ago in December staff on WA's Northern Regions Mobile Van heard that a cyclone was descending on the NW coast where they had mammography screenings scheduled.
The team immediately swang into action. They rearranged the bookings and worked overtime that Saturday to complete mammography screenings for the women in the coastal town of Onslow.
Only then did they pack up their Breastscreen van and make haste to drive some 400 kilometres inland through the Pilbara to Paraburdoo - where they took shelter in a shed for the duration of the cyclone - before getting back to work …
Bill Royce, Dr Wooldridge's Office 02 6277 7220 or 1412 137 699
Mary Shiers, Dept. Health & Aged Care 02 6289 7005 or 0412 108 386