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Finding the cancer at the bottom of the pile

Ian Olver

by Ian Olver

09 May 02:00pm

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Filed under: Bowel Cancer, Budget, Budget 2012, Cancer, Cancer Screening, Health

32 comments

Big winners from last night’s budget include Australians aged 50 and over at risk of bowel cancer – who until now have been among the nation’s most marginalised.

Can't imagine why this is a tough sell… Pic: Mark Brake

The $50 million in new bowel cancer screening funds announced by Wayne Swan and health minister Tanya Plibersek on Saturday may end years of discrimination against a cancer that has been at the bottom of the pile when it comes to understanding and reducing the nation’s overall cancer burden.

The pun was intended. I usually refrain from double entendres when discussing bowel cancer, because it is no laughing matter. We should not make light of a human tragedy – and one that’s all the more tragic because of its preventability.

Bowel cancer is Australia’s second-biggest cancer killer after lung cancer - yet one of the easiest to treat if detected early. However, most Australians do not want to know about bowel cancer, or so it seems.

Surveys have shown that we tend to underestimate the terrible impact it has on our community. Its anonymity has held back progress on proven measures to reduce the mortality it causes.

That may all change following the milestone Government announcement.

The allocation of $49.7 million to expand the National Bowel Cancer Screening Program over the next four years will save hundreds of lives and, because it includes a plan for shifting incrementally to full program implementation from 2017, thousands more deaths may be prevented over the long term.

For 15 years we’ve known bowel cancer screening should be available to everyone aged 50 and over, every two years. At its introduction in 2006 the screening program only targeted people turning 55 and 65 for one-off testing; 50-year-olds were added in 2008.

Thanks to the new budget funds, 60-year-olds will be added next year and 70-year-olds in 2015; the Government plans to thereafter start rescreening everyone aged 50-74 every two years.

Our estimates of the benefits are conservative, as population health research should be. To add context, the program in its limited form over the past three years picked up more than 4000 precancerous polyps and early-stage cancers that could have developed into metastatic disease.

Inviting millions more Australians to screen will translate to tens of thousands of similar interventions.

That the funds were announced as part of a budget focused on reduced spending says two things: It is good value for money; and the Australian Government cares about cancer.

Early detection pays off economically, because it reduces the huge hospital and pharmaceutical costs of treating late-stage disease. But it takes several years for the economic offsets to accrue. So it is clear that saving lives was the Government’s objective; it should be commended accordingly.

The benefits could extend further.

The promise of a fully implemented screening program may bring bowel cancer out of its anonymity and into the mainstream, where it could be rightly seen as a major cause of death in Australia – but one that can be prevented if better understood.

Most commented

32 comments

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    • Anna C says:

      02:46pm | 09/05/12

      Nanny state.

      Reply

    • Caedrel says:

      03:05pm | 09/05/12

      Yes, they’re going to force you to go and get screened for bowel cancer… the funds are for the extra police required to haul you out of home and down to the screening centre…

      *sigh*

    • ZSRenn says:

      03:09pm | 09/05/12

      Yep and next they will be legislating against the consumption of red meat and blaming the health costs of bowel cancer.

    • Chris L says:

      03:13pm | 09/05/12

      “However, most Australians do not want to know about bowel cancer, or so it seems.”

      As an example, please refer to Anna C above.

      Ian, you’re writing to the “what’s in it for me?” crowd here.

    • marley says:

      03:14pm | 09/05/12

      @Anna C - Am I to assume you don’t believe in preventative medicine?  That you have never had a blood test, mammogram, pap smear, vaccination or x-ray?  That you’ve never been to your doctor for a check-up?  Because that’s the only way your comment makes any sense at all.

    • Janine says:

      03:19pm | 09/05/12

      My father was diagnosed with terminal bowel cancer last year at the age of 68.  The cancer, when it was caught, was so far advanced that the original tumour has metastasised and his entire abdominal cavity was covered in hundreds of small cancers.  He now has an estimated life expectancy of 6 months and in that time he will suffer tremendous pain caused by the cancer.

      I have watched him go from a strong,  fit man that was running his own business to a skeleton that is on constant pain.  If there had been a screening program in place and if this cancer was as openly discussed as prostate/breast/cervical cancer then this disease may have been caught in time and would have been able to be treated.

      I usually abhor futher government interference in our lives as there is more than enough now, however in this I fully support this or any government who brings this program in.

    • Kika says:

      03:22pm | 09/05/12

      So mammograms are ‘nanny state’ schemes too?

    • Kika says:

      03:31pm | 09/05/12

      Obviously Anna C never claims her medicare back either. That’s nanny stating as well. Perhaps Anna C would prefer no public health at all. Perhaps Anna C would like to live in the USA.

    • Shane* says:

      03:36pm | 09/05/12

      Nanny State government intervention gave us seatbelts (those bastards!), BAC limits on drivers (fascists!), warning labels on cigarettes (ridiculous!), fluoride in our water (coddlers!) and health programs like BreastScreen (Meddlers!).

      I don’t understand the instinctive reaction from a lot of people to reject the advice of a government that has all the access to all the facts (that we’re generally too lazy to research ourselves) about our health. Frankly I’m glad they make recommendations and rules around my health.

      Without government campaigns who else was going to tell us that alcohol is a cancer risk factor? The Wine Makers Foundation?! Would our local butcher be likely to tell me that consuming lots of processed meat is a bowel cancer risk factor?

      Hmmmm…

    • Budz says:

      03:37pm | 09/05/12

      Troll smile Well played smile

    • Chris L says:

      04:06pm | 09/05/12

      In our defence, Budz, if this is a troll I call Poe’s Law!

    • dancan says:

      04:10pm | 09/05/12

      Wow I’m surprised this topic would stir up such a shit storm

    • Bev says:

      04:41pm | 09/05/12

      @Caedrel The test is done at home and you mail in the sample. Its triple wrapped so danger (or smell) in the postal system.

    • M says:

      04:45pm | 09/05/12

      I’m usually the first one to start screaming about the nanny state, but I’m at a loss as to how you can draw the conclusion that successfull preventative medicine provided free is evidence of the government interfering with our lives.

    • Andrew says:

      03:07pm | 09/05/12

      Really Anna C?

      Reply

    • Anjuli says:

      03:17pm | 09/05/12

      In the UK they do the screening via a home kit sent through the post ,a friend ‘s mother had it done found cancer , too late she died late last year.

      Reply

    • Kika says:

      03:28pm | 09/05/12

      Thank God for that. Or is it only nice cancers get funding - like breast and ovary cancer? I reckon we should start up a brown ribbon appeal. That will get people talking!!` Get over it people. We ALL Poo. Even the Queen. It’s time we start talking about it. It’s just a normal part of the digestive process and it can tell more signs about your health than anything else. Ask a Doctor - or a VET!

      Reply

    • marley says:

      03:30pm | 09/05/12

      I did this test a few weeks ago.  I’d never have thought of it myself, but I went into the Chemist’s for something else, saw the poster for the scan, and asked.  Cost $10 for the kit (it’s a Rotary Project, hence the low cost).  Worth every cent of it for the peace of mind.

      Reply

    • Richard O'Neill says:

      03:31pm | 09/05/12

      Bowel cancer is insidious, I never tested for it, I was outside the age range and was diagnosed at 53. There are a range of problems and illusions around the screening process and it is possible that mine would not have been detected because of its position.
      Today, I am clear, but getting to that point took a 6 hour operation, 8 months of chemotherapy, numerous stays in hospital and about three years recovering from the chemo.
      Believe me, I would have much preferred to have had polyps removed through a relatively simple colonoscopy.
      I have been lucky, because my surgeon is such a genius, I never had a colostomy bag, but that option was a real possibility because of the stage of my cancer.
      There is such an awareness of breast cancer, and testing processes, but colon cancer is the thing that has almost, no air time. I guess things to do with breasts are much “sexier” conversation pieces than discussing organs that process waste.
      That said, neither losing a breast, nor having a colostomy bag conjure up feelings of comfort, but if we can build awareness, utilise screening and diagnose early, lives will be sustained and quality of life for those diagnosed will be vastly improved.
      Congratulations to the government on this initiative, you will be thanked by the many who will be helped through this activity, though few will remember who or how these things were changed.

      Reply

    • Kerryn says:

      03:48pm | 09/05/12

      I always thought of getting a screening kit for my Dad as a joke…maybe I should, not as a joke but to be safe.

      Reply

    • Bev says:

      04:43pm | 09/05/12

      Do it! Cancer is never a joke.

    • MarkF says:

      09:38am | 10/05/12

      Totally agree Bev.  The old girls father died of throat cancer, her mother of stomach cancer, my father of pancreatic cancer and one of the brother-in-laws father of bowel cancer. 

      Watching them wither away in great pain was cruel on them and cruel on all the rest of us.

    • Aussie Battler says:

      04:47pm | 09/05/12

      Good thinking Kerryn. Although it is not always comfortable talking about a subject like this, it is not a joking matter if someone you care about is diagnosed with it.

      Reply

    • delia says:

      04:48pm | 09/05/12

      I have never had a mammagram. pap smear or any others. I wuld rather not know. I am now expecting at 73 that old age will kill me befor a cancer.  My children agree i should leave well alone

      Reply

    • marley says:

      04:59pm | 09/05/12

      @Delia - why wouldn’t you want to know you have a treatable condition?  That boggles my mind. 

      Caught early, many forms of cancer are treatable.  I’ve a relative who got breast cancer when in her early 60s - she’s now a few years older than you are.  An additional almost 15 years of healthy life (so far) has been worth quite a lot to her, her kids and her grandkids.

    • Louisa says:

      09:27pm | 09/05/12

      Delia, your comment horrifies me. I was diagnosed with invasive stage 2b cancer after a pap smear at age 33. That was 21 years ago. Had I had the attitude of putting my head in the sand and not getting tested, I would probably have been dead about 19 years ago, leaving behind a husband and daughters aged 15 and 4 to live their lives without their mother, for no good reason . The majority of cancers these days are treatable and survivable if caught in time.

    • hermano says:

      09:16am | 10/05/12

      Gobsmacked.

    • Ted-e says:

      04:51pm | 09/05/12

      This is simple at-home test. You don’t have to do it, but you would be smart to. Pick bowel cancer up early or as polyps and there is a 90% chance you will live. Once it spreads beyond the bowel (late stage) your chances are grim at about 10%.

      Around 4000 Australians die each year from bowel cancer. As Janine describes, it is a painful, miserable demise. But most of these deaths can be avoided with early detection.

      This program WILL save thousands of lives.

      Reply

    • Kelvin says:

      05:29pm | 09/05/12

      I might be wrong and I hope that I am Ian but if you read the Budget Papers and not the press release I think that you find a very different story.

      The press release presents a very rosy picture for what the Government is doing. $49.7 million extra, and a commitment to expand the program to biennial screening for everyone between 50 and 74.

      The Budget papers released last night say:
      Expansion in 2012-13 $400,000. The remainder to $49.7 to be spent over the next 3 years.
      “The Government will provide $49.7 million over four years to expand the National Bowel Cancer Screening Program to increase the frequency of bowel cancer screening available to all Australians aged between 50 and 74 years.
      From 2013, screening will be available for all Australians turning 60 years of age, and from 2015 screening will also be available for all Australians turning 70 years of age. Biennial screening will be progressively phased in, commencing in 2017-18 starting with Australians aged 72 years. When fully implemented in 2034, the program will provide all Australians aged between 50 and 74 years the opportunity to undergo bowel cancer screening using a Government provided faecal occult blood test every two years.”

      If you read it closely - the scheme will be fully implemented as intended - biennial screening by the year 2034. That is 22 years away.
      Here is the link see for yourself - the programs are listed alphabetically and it is under ‘N’. http://www.budget.gov.au/2012-13/content/bp2/html/bp2_expense-12.htm
      There might be some anomaly in the way that they write these things but Bowel Cancer Australia doesn’t think so under the heading “Federal Budget… 22 years before a complete bowel cancer screening” programhttp://www.bowelcanceraustralia.org/bca/#

      I hope I’m wrong, I fear I’m not.

      Reply

    • Harmless says:

      07:21pm | 09/05/12

      Australia has one of the highest rates of bowel cancer in the world and the major reason is because the average Australian consumes an extremely unhealthy volume of meat, red in particular. There are clear links between higher consumption of red and processed meats in particular ... checkout the findings in this EPIC research for starters - http://epic.iarc.fr/about.php
      Eating less meat, or better still none, is definitely a step in the right direction to reduce the risks of cancer, and for better health all round.

      Reply

    • MarkF says:

      09:39am | 10/05/12

      Let me guess Harmless…your a vege aren’t you?

    • marley says:

      10:39am | 10/05/12

      @MarkF - actually, there is a correlation between high levels of red meat consumption and an increased risk of colorectal cancer.  That’s not to say the risk level is anything like the risk level for smokers, but it does exist.  It doesn’t mean you can’t eat red meat or processed meat, but it does mean it might be a good idea to eat a bit less.  And things like chicken and fish are not a problem, so you don’t have to be a vegan to have a healthy diet.

 
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