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The good and the bad news from the budget on bowel cancer screening

After much agitation over the future of the national bowel cancer screening program, the budget promises $138.7 million over four years to continue the program.

It’s a welcome step in the right direction, but much more needs to be done, says Professor Ian Olver, CEO of Cancer Council Australia.

***

A bigger investment in bowel cancer screening would save many more lives

Professor Ian Olver writes:

The good news is that the National Bowel Cancer Screening Program finally has a long-term future.

The bad news is that Australia will still have to wait for the long term before it can enjoy the program’s full benefits – if the Government sticks to the plan announced in the 2011-12 federal budget.

The Minister for Health, Nicola Roxon, has announced $139 million over the next four years to restart the program as it was at the end of last year – restricted to one-off testing for people turning 50, 55 and 65, rather than being available to all Australians aged 50 and over every two years as the National Health and Medical Research Council recommend.

The most encouraging aspect of the Minister’s announcement is that the program will now be funded recurrently.

Despite being introduced by then Health Minister Tony Abbott way back in the 2005-06 budget – following election promises from the Coalition and Labor in 2004 – until tonight there had been no commitment to permanently fund the program in any form. It had been subject to two separate four-year funding packages (the first backdated to 2004-05), which were more like extended pilots than recurrent funding for a population screening program.

So Minister Roxon should be congratulated. Permanency at last.

The amount itself, however, is a disappointment. An allocation of $139 million might seem like a substantial sum, but it is modest in the context of the program’s potential benefits and health system expenditure more generally.

Recent analyses show Australia is now spending a staggering $1 billion on bowel cancer each year – most of it on high-cost drugs and lengthy hospital stays for people with late-stage disease.

Yet if you detect bowel cancers and precancerous polyps early through screening, when they are much more straightforward to treat, these costs can be dramatically reduced. While some of the bills are picked up by private health insurance and some by state hospital budgets, the Commonwealth still expends a huge amount of federal tax dollars that could be saved if bowel cancer cases were caught early.

And can you put a dollar value on the benefits of a human life saved, or the years of quality life gained for someone who avoids a battle with metastatic cancer? Well, in one sense you can. Not in terms of the intrinsic value of human life, but there are economic benchmarks for prioritising public health investments. Governments have finite resources, so they need some formulae – based on measures such as life-years saved per dollars invested – for guiding funding priorities.

And comprehensive studies from the Cancer Institute of NSW in 2008, and more recently in the Medical Journal of Australia, show the expansion of the National Bowel Cancer Screening Program is one of the best public health investments available to the Australian Government.

It is without question the best investment in preventing cancer deaths in the immediate and long term. Government just needs to increase its investment and the returns will increase too.

So where to from here?

Let’s give Minister Roxon the credit she deserves for the National Bowel Cancer Screening Program finally acquiring permanent status, albeit in restricted form. The Minister has always been a supporter of the program and she probably pushed strongly for its resumption and recurrent funding.

But non-government advocates for reducing Australia’s bowel cancer toll will not wait patiently until 2015 for the program to be expanded beyond its modest population reach.

By the time the 2012-13 budget is announced, another 4000 Australians will have died from bowel cancer – many of whom would have been saved if a full screening program were in place.

***

More from Croakey…

In other cancer announcements in the budget:

• An extra $6 million to help the National Centre for Gynaecological Cancers by providing resources to health professionals for treatment, commissioning research and clinical trials, and maintaining information resources for consumers.

• An extra $4 million to the Prostate Cancer Foundation of Australia to deliver support and management aids for men with prostate cancer and their families and carers.

Comments 5

  1. SoulmanZ says:

    How much funding would ther program reasonably require? How deficient is the funding? How well will what they have offered cover the population?

    Cheers

  2. Paul Grogan says:

    SoulmanZ: Latest independent estimates (MJA, Feb) says a gross annual investment of around $150m is required for full coverage of the program, but substantial offsets in hospital and PBS costs would reduce this to circa $50m per annum net over time. This is highly cost-effective. The current program is a one-off test for people turning 50, 55 and 65, instead of available to everyone 50 and over biennially as recommended by the NHMRC. That equates to around 5 million people who should be invited to screen missing out. So, while the budget funding is welcome, there is a clear case for bringing forward any plans for the program’s expansion. – Paul Grogan, Cancer Council Australia

  3. Paul Grogan says:

    Please note error above. Net costs would require a $50m increase on current investment of circa $30m per annum. Net costs for the program long-term are estimated at around $80m p.a. Apologies for the error. PG

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