The sorry state of women’s health in Australia is confirmed in grim new global report – as personal trainer, 28, witnesses dismissal first-hand days before shock cancer diagnosis

At 28, Helene Duncan was fit, healthy, planning a wedding and preparing to begin a master’s in exercise physiology.

The Brisbane personal trainer spent her days teaching others how to look after their bodies, so when crushing fatigue began following her everywhere she blamed the obvious culprit: a busy life.

‘I had a lot of fatigue that I brushed off as workload,’ Helene told the Daily Mail.

‘I was asking myself, “Am I depressed, or am I tired? What is going on?” I just felt fatigued all the time.’

Then she found a lump in her breast while showering.

Within weeks, Helene was diagnosed with stage two breast cancer, placing her among a growing number of younger Australian women confronting a disease many still assume primarily affects those old enough to be routinely screened.

Her diagnosis comes as a landmark global report reveals Australian women’s health is deteriorating across several major measures, with fewer cancer checks, worsening emotional distress, and mounting financial pressure.

The latest Hologic Global Women’ Health Index found fewer than one in four Australian women and girls aged 15 and older had been tested for cancer in the previous year.

Australia still ranks slightly above the global average, scoring 59 out of 100 compared with 54 worldwide, but health advocates warn the country is moving in the wrong direction.

This comes particularly as younger breast cancer patients continue to expose troubling gaps in awareness, early detection, and access to screening.

There was no known family or genetic history of breast cancer, and at 28, Helene was decades younger than the women routinely invited to participate in the national breast screening program.

She immediately told her partner, who reassured her it was probably nothing but urged her to book an appointment with her GP the next day. 

Her doctor immediately referred her for an ultrasound and mammogram, which she attended the next day.

The first reaction she received at the radiology clinic briefly gave her hope.

‘When I arrived, they raised their eyebrows and said that because I was under 35, I probably wouldn’t need a mammogram,’ Helene said.

‘They said they would do the ultrasound first and then decide from there.’

The tone in the room changed as the scan continued. The sonographer became quiet while examining the lump, and the images were sent to the head radiologist.

‘They immediately said, ‘Get her in for a mammogram now, and book her for a biopsy as soon as possible’,’ Helene recalled.

‘Originally being dismissed gave me a bit of false hope. I thought, ‘If they’re not worried, I’m not worried’.’

‘Then it became an emotional rollercoaster because the woman doing the ultrasound suddenly became very quiet, and she started talking about needing a mammogram.’

The clinic rearranged appointments so Helene could undergo further imaging that day and return for a biopsy on the Monday.

Two days later, she sat in her GP’s office waiting for the results. The written pathology report had not yet arrived, but her doctor had already seen the scans and did not want her left in limbo.

Helene was diagnosed with invasive ductal carcinoma.

Full-body scans later revealed the disease had spread from the primary tumour to two lymph nodes, placing it at stage two.

She is now undergoing chemotherapy and immunotherapy, with treatment expected to continue until November before doctors assess how the tumour has responded and determine what surgery will be required.

Helene’s experience forms a deeply personal counterpoint to the wider findings in the Hologic report, which examines women’s health in 144 countries across preventive care, individual health, emotional health, basic needs, and perceptions of safety.

Aggie Cox, a spokesperson for the Hologic Global Women’s Health Index, said the project was created because reliable data is essential to improving outcomes.

‘You can’t improve what you don’t measure,’ she told the Daily Mail.

The global survey collected responses from approximately 145,000 people in 140 languages, with the Australian data revealing both clinical and social pressures.

Only 23 per cent of Australian women surveyed said they had been tested for cancer in the previous 12 months.

Diabetes testing sat at 36 per cent, while testing for sexually transmitted infections was reported by just 10 per cent.

Blood pressure screening increased to 56 per cent, offering one of the few positive preventive care trends.

Ms Cox said the results showed that women’s health could not be understood solely through access to doctors or clinical treatment.

More than one in five Australian women reported struggling to afford food in the previous year, while approximately one in nine struggled to afford shelter.

Australia’s Basic Needs score fell from 92 to 84 over the five-year reporting period, representing one of the largest declines across any of the measured dimensions.

The emotional impact was equally significant.

More than half of Australian women reported feeling stressed for much of the previous day, compared with a global average of 38 per cent, while 41 per cent experienced worry.

Women also reported more sadness and anger than they had at the beginning of the survey.

‘The data doesn’t examine exactly why, but when we look across the five dimensions, we can see more women struggling to afford food and shelter,’ Ms Cox said.

‘When you have those economic pressures, chronic pain, and other sources of stress, that is more likely to show up in emotional health as well.’

Almost half of Australian women also said they did not feel safe walking alone at night in their communities.

Ms Cox said this was not an abstract concern and could directly limit women’s participation in daily life.

‘I definitely consider where I am going to park, and sometimes it affects whether I go out at all,’ she said.

‘If I knew I would be in a dark place alone at night, I would consider whether I participated in that activity.’

Taken together, she said the findings illustrated why women’s health policy must consider emotional, social, and economic, wellbeing alongside testing and treatment.

‘There is more to be done when it comes to women’s health, and women’s health is made up of more than just the clinical,’ she said.

‘We need to consider women’s emotional, social, and economic position as well.’

The breast cancer screening divide

Australia’s national breast screening program actively invites women aged 50 to 74 to have a free mammogram every two years, while women from 40 can also access screening.

Younger women such as Helene do not fall within the routine screening population, partly because breast cancer is less common at younger ages and mammograms can be less effective in women with denser breast tissue.

However, diagnoses among younger women have fuelled calls for greater awareness of symptoms and clearer information about what to do when something changes.

Helene said she did not expect to be screened routinely at 28, but believes younger women need a better understanding that breast cancer remains possible well before 40.

‘There seems to be a very big gap in preventive strategies between younger women and women over 40,’ she said.

‘Younger women don’t always have the information. Since being diagnosed, I’ve had so many young women tell me they learned to do a self-check or started doing self-checks because they saw me speaking about my diagnosis.

‘There is a disparity in awareness, and young women may not realise that you can get breast cancer under 30, or definitely under 35.’

Specialist breast surgeon Professor Bruce Mann said diagnosing breast cancer at its earliest stage remained one of the most effective ways to reduce treatment and improve survival.

‘When a cancer is diagnosed at the earliest stages, the amount of treatment needed is much less than when it is diagnosed later,’ he said.

‘The outcomes are also much better, and the chance that a person will die from breast cancer is much lower. It is therefore critical that, as much as possible, breast cancer is diagnosed early.’

Professor Mann said BreastScreen was available to women in the target age group, but participation remained only slightly above half of those eligible.

‘If participation is around 52 or 53 per cent, that means many women who are eligible for funded screening do not take part,’ he said.

‘It is important that we work out why that is and address it, because early diagnosis in breast cancer, and many other cancers, is the key to better outcomes.’

The reasons women do not attend screening are complex and can include fear, competing caring responsibilities, limited awareness, discomfort, cultural barriers, geographic access, and the mistaken belief that screening is unnecessary without symptoms or family history.

Professor Mann said the next major development could be risk-adjusted screening rather than relying almost entirely on age. Researchers may be able to identify the 10 to 15 per cent of women at greater risk and offer them specialised screening. 

A forthcoming BreastScreen Victoria trial known as MyScreen will examine risk using a combination of family history and mammographic density. 

He was also careful not to frame the shortcomings in women’s healthcare as evidence that men’s health was universally prioritised.

‘I think it is artificial to one-up one over the other,’ he said.

‘Men do not look after their health, and men die around seven years younger.

‘There are different diseases and different problems, and they are all important. We are all in this together.’

Professor Mann said there were nevertheless clear areas in women’s health where care and early detection could be improved.

Breast cancer is primarily a women’s disease, and the consequences of delayed diagnosis can be profound.

Helene’s stage two diagnosis came after she found the lump herself and acted quickly. Other younger Australian women have faced far longer and more devastating journeys.

Chontaine Adair, a mother-of-two from south-west Sydney, was 31 when she first woke with unexplained and excruciating pain through her ribs and back.

She could barely roll over, struggled to walk, and found it painful even to bend down and hug her daughters.

Despite repeatedly seeking medical help over the following year, she was told the pain was muscular.

‘I kept saying that I hadn’t pulled a muscle,’ Chontaine told the Daily Mail.

‘I hadn’t injured myself. It had just started out of nowhere in the middle of the night.’

The pain repeatedly disappeared and returned, sometimes lasting several weeks at a time. After hospital visits and follow-up appointments produced the same explanation, Chontaine stopped seeking help.

‘I thought, “The doctors aren’t going to do anything. There’s no point going back”,’ she said.

When the pain eventually returned and did not subside, a CT scan revealed secondary tumours in her spine and rib.

She was diagnosed with stage four hormone receptor-positive breast cancer that had spread to her bones. Her oncologist believes the cancer was probably already metastatic when the original pain began.

Chontaine was just 32 when she received the incurable diagnosis, and her immediate fear centred on her children.

‘I remember just crying,’ she said.

‘I was thinking, “How long have I got? Am I going to make it? Is there treatment? Is it terminal?” Mostly, I was thinking about my girls. I need to be here for them.’

The contrast between Helene’s and Chontaine’s experiences demonstrates the difficulty of designing screening policy around younger women.

Routine population screening must weigh benefits against harms, including false positives, unnecessary biopsies, radiation exposure, and the reduced accuracy of mammography in dense breasts.

At the same time, age-based assumptions can create false reassurance when younger women present with genuine symptoms.

Professor Mann said screening should never replace breast awareness.

Any new and unexplained change in the breast should be investigated, regardless of age. Symptoms can include a lump or thickening, nipple discharge, skin changes, or, less commonly, persistent pain.

‘Women need to know what their breasts normally feel like,’ he said.

‘If something has changed, if it is different, and particularly if it persists for more than a couple of weeks, make sure it is investigated.’

Helene believes younger women should feel confident insisting that a concerning change is properly assessed.

‘Looking back, I think it is awful that people can easily be dismissed based on their age,’ she said.

Her diagnosis does not mean every young woman needs routine mammograms, nor does a lump automatically mean cancer.

Most breast changes are benign. However, experts agree that symptoms should not be disregarded simply because a woman falls outside the standard screening age or has no family history of the disease.

Lower screening rates are only one part of the picture.

A woman struggling to pay rent, feed her family, manage unpaid care, work through chronic pain, or avoid unsafe public spaces may have less time, energy, and confidence to prioritise preventive appointments.

The report does not establish that one problem directly causes another, but its findings show they frequently exist together.

Australia remains wealthier, safer, and better resourced than many countries included in the index, and its overall women’s health score remains above the global average.

The country also provides publicly funded cancer screening, universal Medicare access, advanced cancer treatment, and emerging research into personalised screening.

Yet those strengths do not erase the number of women who remain unscreened, financially strained, emotionally distressed, or uncertain about which symptoms require investigation.

Helene’s story is not evidence that every tired young woman has cancer, nor that national screening should automatically be extended to all women in their twenties.

It does, however, show why awareness, responsive primary care, and careful investigation remain critical when a person notices something new.

She was young, physically active, had no known family history, and initially believed her exhaustion was the result of an overloaded schedule. A lump discovered by chance in the shower changed everything.

‘I would like younger women to understand that breast cancer can happen under 30,’ she said.

‘Know your body, know what is normal, and get any changes checked.’