Proper screening could save lives and save us millions
The word ‘cancer’ still strikes fear into the minds of many people. The idea that a person can be walking about, apparently healthy, but secretly hosting a opportunistic disease which may have no cure, remains a concern for many. Add the rigours of chemotherapy treatment, and it is easy to understand the sentiments.
Yet some of the most common cancers can be prevented, or treated successfully, if detected early enough. Breast cancer is an example. A free screening program was introduced in 1991.
It provides free biennial mammograms to women aged 50 – 69 with no clinical manifestations of malignancy. Women in their 40s and over 70 can also access the program. The cost of the service is about $150 million a year.
According to the Cochrane Collaboration, an authoritative source on the effectiveness of health care interventions, for every 2000 women invited for screening throughout 10 years, one will have her life prolonged.
The death rate from breast cancer has fallen from 30 per 100,000 women in 1994 to 22 per 100,000 women in 2008. (The actual numbers increased slightly from 2,655 in 1994 to 2,788 in 2008).
According to various studies, the cost-effectiveness of the screening ranged from approximately $20,000 to $50,000 per life year saved.
By comparison, bowel cancer kills 4,000 Australians each year – a rate of 73 each week. The incidence is expected to increase by up to 10 per cent a decade. Yet more than 90 per cent of these cancers can be cured if detected early.
The National Health and Medical Research Council guidelines recommend screening for bowel cancer at least every two years from age 50. This is because bowel cancer often develops without symptoms.
Despite these national health guidelines the current National Bowel Cancer Screening Program offers just one-off screening and is only available to those lucky enough to be in one of three select age groups – those turning 50, 55 or 65 before December .
There has been no commitment to the Program beyond this year. More than five million Australians aged over 50 are missing out on a simple test that could save their lives.It costs about a billion dollars a year to treat bowel cancer. Yet for about $150 million per year, all Australians over 50 could have the simple screening test.
About one in 20 people having the faecal occult blood testing require a colonoscopy. Eleven per cent of these are detected with cancer. According to data from Biogrid Australia, 41 per cent of cancers found through screening are at the most curable stage, compared with just 18 per cent found outside the Program after the presentation of symptoms.
Screening also detects 19 per cent of patients with an advanced adenoma and 16 per cent with a small adenoma, which can be readily treated with the removal of the polyps.
If fully implemented, the National Bowel Cancer Screening Program could prevent 1,300 cancer deaths each year.
Providing free two-yearly screening for every Australian over 50 will result in substantial savings in hospital costs. Removing a precancerous polyp detected through screening costs around $1,600, while treatment at a public hospital for bowel cancer can cost in excess of $70,000.
Over the past three years, the Labor government has wasted billions of dollars on handouts, pink batts, inadequate school halls and the like, while failing to guarantee a health prevention program that would save the lives of people and comfort many family members.
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