The current status of radiographers as screen readers in breast screening units: applications for Australia

Abstract

In the United Kingdom's National Health Service BreastScreen Program, three‐quarters of their screening units have radiographers as one of the two independent screen readers. This has been the case since the early 1990s. Multiple studies confirm the capabilities of radiographers as screen readers and the positive outcomes for the stakeholders. This is not the current practice in BreastScreen Australia, despite the chronic and increasing shortage of radiologists in general and in particular radiologists willing to be accredited in BreastScreen. This discrepancy in practice led to a qualitative investigation of the perceptions of radiographers, radiologists and directors involved in BreastScreen Australia and eligible users of the service, regarding the role of radiographers as screen readers. The perceptions of these Australian stakeholders were collected via interviews and personal correspondence. Thematic analysis was conducted on the data and then triangulated with a thematic analysis of the literature. This research demonstrated positive perceptions towards radiographers as screen readers for BreastScreen Australia by the Australian stakeholders. This was supported and reinforced by the literature review, in particular, the UK experience of radiographers as screen readers. Therefore, given the advantages of radiographer role extension and increased career opportunities, in conjunction with the increasing workload of the Australian radiologist, it would seem prudent to commence planning for the introduction of non‐radiology screen readers in to BreastScreen Australia. This paper provides an initial basis from which to commence discussion and planning by all the Stakeholders.

The Australian BreastScreen workforce: a snapshot

“…6,[8][9][10][11][12] Other options to increase radiographer numbers may include making provisions for Assistant Practitioners, following the UK four tier model 13 or allowing male radiographers to perform mammograms in the currently female dominated BreastScreen setting. The Newcastle BreastScreen Service recruited radiographers from overseas (mainly the UK and Canada) between 1991 and 2004 due to a lack of available mammography trained workers in this country.…”

Development of a training package to increase the performance of radiographers in assessing screening mammograms

“…2 Th is shortage of radiologists is more acute in the fi eld of breast imaging, due to perceptions that it is not as stimulating, not as lucrative as other radiological modalities and carries a higher risk of litigation issues. 3,4 BreastScreen Australia programmes undertake double reporting routinely. 5 It has been documented that the more readers looking at the same images results in more cancers being detected; 6,7 however this has to be balanced against increases in the recall and false-positive rates which are not cost-eff ective for BreastScreen programmes.…”

Radiographers as screen readers – are we there yet?

“…Radiographers as screen readers in Australia has been the recent focus of articles published in Th e Radiographer [1][2][3] and elsewhere. 4,5 Th is renewed interest prompts a review of the current situation in Australia together with considerations of a way forward.…”