From campaign to change: The story behind extending breast screening to age 74

Every few weeks, former Health Minister Dr Shane Reti receives unexpected emails from New Zealanders who have felt the impact of the expanded free breast screening programme.

Some write to say it saved their mother’s life. Others say it saved their wife’s life, or their own.

“I don't know these people,” Dr Reti says. “These messages are unprompted from New Zealanders who are grateful for how they’ve been impacted by this policy change.”

For eight years, Breast Cancer Foundation NZ campaigned for breast screening eligibility to be widened so more women could benefit from the life-saving benefits of mammograms.

That relentless advocacy culminated in a major change to New Zealand’s breast screening programme. In 2024, a pilot was launched to raise the upper age limit for free mammograms from 69 to 74, and the age extension began to roll out nationwide in October 2025.

This change is already saving lives. Since the start of national rollout, more than 24,400 women in the new age group have had mammograms, and more than 330 breast cancers have been detected early in women who previously would have missed out on screening. That’s hundreds of women who were able to get an early diagnosis, making the chance of successful treatment and survival much higher.

Behind the policy change was years of dedicated work by the Foundation to build the evidence, raise awareness of the gap in screening access, and advocate for action.

To mark one year on from the launch of the age extension’s national rollout, we sat down with Dr Reti to reflect on the journey that turned a long-standing campaign into government policy, and the role the Foundation’s advocacy played in helping make it happen.

Making the case for change

The evidence was undisputable – a woman’s risk of breast cancer is higher at 70 than it is at 50 so it made no sense to stop free screening at 69. We repeatedly took this evidence to decision makers and persisted in keeping the issue visible.

For Dr Reti, the issue became one he was determined to back.

“Being a clinician, as well as having a partner who is a breast cancer survivor, I’ve seen the impact of this disease up close,” he says.

“New Zealand has one of the highest rates of breast cancer in the world. That’s what motivated me to champion this issue.”

The path to becoming government policy

Before becoming Health Minister, Dr Reti began pushing for change from the opposition benches, believing extending screening would save lives and improve outcomes. But turning that idea into policy was far from straightforward.

The proposal first had to gain support within caucus. His private member’s bill was then selected from Parliament’s ballot – which has odds of less than 5% – before eventually progressing through government and securing funding through the Budget process.

“It was a remarkable journey going from having a great idea I believed in while I was in opposition, all the way through to making it a reality. I had the drive to keep the idea moving, but there was luck involved as well.”

Dr Reti believes his clinical background helped him navigate the process.

“I understand the breast cancer pathway, and I was able to discuss this in detail and address the hurdles.”

Why earlier detection matters

At the centre of the argument was a simple principle: early detection saves lives.

“For many conditions, and particularly for cancer, it's really simple – if you detect it early, you get a better outcome.

“Screening by definition is population-based early identification. Early detection means less burden on patients and less burden on the health system.”

Seeing the impact

Now, the real-world impact has exceeded expectations.

“The outcome has been way better than I ever imagined. The pick-up rate has exceeded what we expected.”

And it’s the messages arriving in his inbox that have stayed with him.

“I look back at this and in my career, I may have saved more lives with this policy than anything else I’ve done.”

For Breast Cancer Foundation NZ, this is what advocacy is all about. Identifying where the health system needs additional resource, building the evidence for change, and staying committed until the system changes.

Because behind every statistic is someone diagnosed earlier, with a greater chance of successful treatment and being given the opportunity to live and live well.