Free, 20 minutes, no referral: why South Asian women in Australia skip the mammogram

The screen is free, the appointment takes about 20 minutes and no referral is needed. Yet over the two years 2022 and 2023 only 39.9 per cent of women aged 50 to 74 who speak a language other than English at home were screened through BreastScreen Australia, against 53.9 per cent of those who speak English at home. October is Breast Cancer Awareness Month, and a study published in August by researchers from Deakin University, the University of Melbourne and Melbourne hospitals explored the barriers and facilitators to breast screening for South Asian women in Victoria.

What the study found

“Understanding barriers and facilitators to breast cancer screening: insights from South Asian women and general practitioners in Victoria, Australia” appeared in the Australian Journal of Primary Health on 7 August 2026. Farwa Rizvi and colleagues interviewed 25 women of Indian and Pakistani background aged 35 to 65 living in Victoria, and nine female GPs practising in metropolitan settings, between October 2023 and December 2025, with interviews conducted in English, Urdu or Hindi according to participant preference. The Shepherd Foundation Victoria funded the work and had no role in its design, analysis or write-up.

The women described barriers at individual, interpersonal, organisational, community and policy levels. “It’s just that it’s going to be painful,” said one woman over 50. “This (cancer) itself is such a scary word,” said another. A woman under 50 said: “I think because culturally we don’t discuss this as its kind of sensitive. People who are from the older generation, especially my mother’s generation, they don’t talk about it.”

“It is difficult with a full-time job and family even if older kids. It gets very difficult to take time off during the workdays to go for screening …” said a woman under 50. A woman over 50 said: “If I’m working 5 days a week and I’m on the phone for almost 45 minutes just to get the booking for it, and then there is a 3–4 months waiting, I will lose interest.” A GP said: “the wait lists are still quite long, anywhere between 4–5 weeks, depending on the area.”

The permission problem

One woman over 50 said of her GP: “She [GP] never, ever mentioned it (breast screening). She should have.” A woman under 50 told the researchers: “Many women need husband’s permission to even go or even to take them to the doctor, because they’re still not independent and there’s a language barrier as well.” A GP said: “Many women are dependent on their husband not only for the financial decisions, but also about the healthcare accessibility… Only if the husband thinks it is important.”

“My husband said it’s important and I should go, so I went for it (breast screening),” said one participant over 50. The paper lists family support, encouragement from GPs, availability of female staff, trusted translators and community networks among the facilitators.

Participants’ recommendations included proactive GP–patient communication, family-inclusive messaging, promoting awareness of female staff, and “automated, multilingual text reminders”. The paper’s conclusion is that primary care “has an important role in improving screening awareness and participation through culturally sensitive communication, proactive screening discussions and community-based outreach strategies.”

What the numbers say

The Australian Institute of Health and Welfare’s 2025 monitoring report, the source of the 39.9 per cent figure, shows national participation among women aged 50 to 74 at 52 per cent over the two years 2023 and 2024, up from 47 per cent in 2020 and 2021, a fall the AIHW attributes to the COVID-19 pandemic, and still below the 53 to 54 per cent recorded before it. In 2023, 6,410 participants aged 50 to 74 had an invasive breast cancer detected through the program.

The Cancer Institute NSW’s performance index puts biennial participation by culturally and linguistically diverse women aged 50 to 74 at 40.2 per cent for 2024-25, up from 39.0 per cent in 2019-20. In the Western Sydney Local Health District, a Westmead Breast Cancer Institute release in October 2025 said 64 per cent of culturally and linguistically diverse women were overdue for their two-yearly screen, with more than 700 local women expected to be diagnosed that year.

Cancer Australia estimates 20,336 new breast cancer diagnoses in Australia in 2025 and 3,353 deaths, with five-year survival of 93 per cent for those diagnosed in 2017 to 2021.

Who is doing what

BreastScreen Australia is a joint initiative of the Australian and state and territory governments that offers a free mammogram every two years to women over 40 and actively invites those aged 50 to 74. Bookings go through 13 20 50, which connects to the nearest service for the cost of a local call. The federal health department’s guidance says you “don’t need a doctor’s referral” and to tell BreastScreen if you need an interpreter. Women with a family history of breast or ovarian cancer are told to talk to their doctor.

BreastScreen NSW publishes its factsheet in 27 languages, including Hindi, Bengali and Tamil, though not Punjabi, Gujarati or Urdu. Its 2026 “Breast Cancer Doesn’t Wait” campaign ran from 1 February to 28 March and produced in-language assets for Mandarin and Cantonese speakers, targeting areas including Blacktown, Cumberland, Fairfield, Liverpool and Canterbury-Bankstown. A permanent clinic at Level 1, 2 Warrick Lane, Blacktown, announced in November 2024, opened in August 2025; it is open six days a week and is expected to serve more than 85,000 women who live and work in the area. Associate Professor Nirmala Pathmanathan, Director of BreastScreen NSW, Sydney West Screening Assessment Service, said: “If you’re aged 50 to 74, make breast screening a priority. It only takes 20 minutes and no doctor’s referral is needed.”

BreastScreen Victoria’s translated resources cover Hindi, Punjabi, Tamil, Nepali, Sinhalese and Malayalam, with interpreters on 13 14 50, and it runs a clinic on Bethany Road in Tarneit. In 2021 it said the Featherbrook Community Hub in Wyndham had helped it engage the Hindi-speaking community.

The National Breast Cancer Foundation, established in 1994, says Breast Cancer Awareness Month takes place every October, and that 56 people in Australia are diagnosed every day and nine die.

What to do this month

If you are between 50 and 74 and have not had a mammogram in two years, ring 13 20 50. If you have a family history of breast or ovarian cancer, talk to your doctor. If you need an interpreter, tell BreastScreen when you book. One participant, speaking of her GP, said: “She should have.”