Australian Government Department of Health and Ageing
BreastScreen Australia Program
Photos of Women

BreastScreen Australia Evaluation

BreastScreen Australia is currently undergoing a comprehensive evaluation to assess the appropriateness, efficiency and effectiveness of the Program.

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Background

BreastScreen Australia was established in 1991. The Australian Health Ministers’ Advisory Council (AHMAC) agreed, in October 2005, to a comprehensive evaluation of BreastScreen Australia to be overseen by a committee of Australian and international experts.

The Program has been fully operational for over ten years with several cohorts of women participating in screening at two-yearly intervals so that the Program’s health outcomes can now be measured effectively. An evaluation at this point of time will allow for the Program’s impact to be measured and future directions determined.
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Aim

The aim of the BreastScreen Australia evaluation is to assess the appropriateness, efficiency and effectiveness of the Program. The evaluation will also address the ongoing and emerging issues that have an impact on the Program, and identify opportunities for overall improvement.

The evaluation will examine the benefits of the Program in terms of reduction in breast cancer death rates through a comprehensive study of mortality, and will also examine the risks associated with screening. It will consider the appropriate target age range, screening interval, issues impacting on the Program’s capacity such as workforce issues, and Program performance to date. The evaluation will include an examination of participation rates and factors affecting participation.
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Objectives

The Australian Health Ministers’ Advisory Council (AHMAC) has endorsed the following objectives for the evaluation:
  • assess the outcomes delivered by the Program;
  • assess the extent to which the Program has achieved its aims and objectives;
  • assess the appropriateness, efficiency and effectiveness of the Program;
  • assess, and address the ongoing and unresolved issues impacting on the Program; and
  • identify opportunities to improve the Program overall.
To achieve its objectives, the evaluation will consist of a range of evaluation projects aimed at assessing:
  • health outcomes – the benefits and risks of the Program;
  • process outcomes – efficiency of the implementation of the Program; and
  • economic outcomes in relation to the cost-utility, cost-benefit and cost-effectiveness of the Program.
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Evaluation Plan

The Department of Health and Ageing has developed an evaluation plan which was finalised by the BreastScreen Australia Evaluation Advisory Committee (EAC) at its inaugural meeting and endorsed by AHMAC in March 2007. The evaluation will consist of a number of individual projects:
  • a mortality study (part 1) to identify suitable methodologies to assess the impact of mammographic screening on breast cancer mortality;
  • a mortality study (part 2) to analyse relevant data to assess the impact of BreastScreen Australia on breast cancer mortality;
  • an analysis of participation and performance trends using existing BreastScreen Australia monitoring data;
  • a review of the Program’s capacity including infrastructure and workforce issues; and
  • a policy analysis project to analyse the target age range, screening interval and screening of women considered to be at a higher risk of breast cancer.
  • a review of the accreditation process;
  • a qualitative study to assess issues relating to participation, access and equity and morbidity;
  • a review of Program governance and management arrangements including the funding and reporting arrangements; and
  • an economic evaluation.
BreastScreen Australia Evaluation Plan (PDF 121 KB)
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Reporting

A final report will consolidate the outcomes of the all the projects and comprehensively address the terms of reference set out by AHMAC for the evaluation. It will also assess the appropriateness of the Program’s objectives, and provide recommendations for AHMAC’s consideration.
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Governance arrangements

The evaluation will be overseen by the Evaluation Advisory Committee (EAC) comprised of eminent Australian and overseas experts, jurisdictional representatives and consumer representatives. The EAC reports to AHMAC via the Australian Population Health Development Principal Committee (APHDPC).

Members
Category
Expertise
Dr Helen Zorbas
Director
National Breast and Ovarian Cancer Centre
Chair and Australian expertPracticing breast physician; population health expert; evidence based practice, clinical guidelines, monitoring, service improvement and psychosocial support to improve breast cancer care.
Dr Frida Cheok
Consultant
Australian expertHealth economist and epidemiologist, experience in health services research and monitoring and evaluation of the BreastScreen Australia program.
Professor David Currow
Chief Executive Officer
Cancer Australia
Cancer Australia representativeCancer care and cancer research.
Professor Dallas English
Director
Centre for Molecular, Environmental, Genetic and Analytical Epidemiology
The University of Melbourne
Australian expertCancer epidemiology, environmental and genetic determinants of breast, colon, prostate and skin cancer.
A/Professor Harry de Koning
Epidemiologist
Erasmus Medical Centre
The Netherlands
International expertMonitoring and evaluation such as the evaluation of the national breast cancer screening programme in the Netherlands and screening women at high risk using alternative screening technologies.
Ms Valerie Lang AMConsumer RepresentativeConsumer Health Forum representative.
Mr David Learmonth
Deputy Secretary
Department of Health and Ageing
Department of Health and Ageing representativeHigh level policy expertise.
Mrs Jennifer Muller
Director
Cancer Screening Services Unit
Queensland Health
Jurisdictional member (large jurisdictions)Management of screening programs in Australia, monitoring and evaluation.
Clinical A/Professor Jonathan Osborne
State Radiologist
BreastScreen Queensland

Australian expert Radiologist with expertise in the BreastScreen Australia.
Mrs Julietta Patnick
Director
The National Health Service (NHS)
Cancer Screening Programs
United Kingdom
International expertManagement of cancer screening programs and evaluations such as the review of the NHS Breast Screening programme and economic evaluations.
Professor David Roder
Head of Centre for Cancer Control research; and
Associate Director of the Cancer Epidemiology Centre, Cancer Council of South Australia
Jurisdictional member (small jurisdictions)Epidemiology of breast cancer, and health services research.
Ms Venessa TrippConsumer representativeFormerly a Senior Executive Service Officer in social policy areas of the Australian Public Service.
Dr Madeleine Wall
Clinical Leader, BreastScreen Aotearoa, National Screening Unit, New Zealand
ObserverRadiologist; management of breast cancer screening programs.

The EAC’s role is to:
  • advise on the specific terms of reference for the overall evaluation;
  • provide advice on the evaluation plan;
  • prioritise specific evaluation projects;
  • endorse terms of reference and specifications for each project;
  • provide technical advice on the selection of tenders;
  • brief the evaluators and provide technical advice to support the evaluation;
  • consider progress and draft reports; and
  • submit the final report and recommendations to AHMAC.
The role of the Department of Health and Ageing is to:
  • provide secretariat support to the EAC;
  • develop the terms of reference for all the evaluation projects, in consultation with key stakeholders;
  • undertake necessary procurement processes;
  • manage the overall evaluation project and some of the individual projects associated with the evaluation;
  • consult with technical experts as required; and
  • provide updates to AHMAC.

Funding

The BreastScreen Australia evaluation is being jointly funded by the Australian, state and territory governments, reflecting the funding arrangements for the BreastScreen Australia Program and the division of responsibilities between the Australian, state and territory governments.

News/updates

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Contact us

All queries on the BreastScreen Australia Evaluation can be sent to cancerscreening@health.gov.au


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Page currency, Latest update: 13 March, 2008