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Finding the cancer at the bottom of the pile

May 29, 2012

Finding the cancer at the bottom of the pile

Big winners from last night's budget include Australians aged 50 and over - who until now have been among the nation's most marginalised.

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.

This blog post also appeared on The Punch.