Challenges and opportunities for Aotearoa/New Zealand’s breast screening programme

Abstract

Around 3500 New Zealand women will be diagnosed with breast cancer each year. Of these, 45% will be diagnosed through mammography screening, either through BreastScreen Aotearoa or through the private sector. Those diagnosed through screening have better outcomes and importantly more equitable outcomes for Māori and Pacific women. With the advent of many technological changes, there are opportunities to increase the proportion of women who are diagnosed early through systematic screening and thus improve overall mortality from breast cancer. This article discusses the potential opportunities including widening the screening age and addressing the differences in screening rates for Māori and other ethnicities. The review also discusses potential changes to the screening modality (mammography), the value of grading breast density and the use of personalised screening. Finally, the article addresses the potential uses of Artificial Intelligence in assessing risk of cancer and in improving diagnostic accuracy of mammography.