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Federal Budget 2011

May 11, 2011

The "pretend" bowel cancer screening program is an opportunity lost

Kathy Flitcroft, from the Sydney School of Public Health at the University of Sydney, has

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Kathy Flitcroft, from the Sydney School of Public Health at the University of Sydney, has previously described the Federal Government’s policy failures around bowel cancer screening.

The budget’s announcements on bowel cancer screening (as outlined by Cancer Council Australia’s Professor Ian Olver last night) add to her sense that the Government’s commitment evidence-based policy is grounded more in rhetoric than action.

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Where’s the commitment to evidence-based health policy?

Kathy Flitcroft writes:

The Budget announcement of $138.7 million for the continuation of the current bowel cancer screening program is a clear indication that the ideal of evidence-informed health policy is seriously challenged in Australia.

Health Minister Nicola Roxon recently justified the decision to ignore recommendations from the Pharmaceutical Benefits Advisory Committee (PBAC) to fund six pharmaceuticals on the basis that this money was needed for the bowel cancer screening program.

Those who had demonstrated that the current program was underfunded and inadequate, dared to hope that a better, more evidence-based program was on the way. Unfortunately, this was not the case.

This government has opted to not only ignore the expert opinion of the PBAC, which makes recommendations about placing drugs on the Pharmaceutical Benefits Scheme based on the best evidence, but has then also ignored the pleas of Cancer Council Australia, gastroenterologists and academics who have made a strong case for the need for increased funding for bowel cancer screening.

Done properly, this evidence-based and cost-effective intervention can save not only 1,000 lives a year but can also reduce costs for our overstretched health system.

By continuing to restrict funding of faecal occult blood test (FOBT) screening to those turning 50, 55 and 65, the government has ignored the recommendations from its own National Health and Medical Research Council on how bowel cancer screening programs need to be implemented.

The evidence clearly shows that FOBT screening should be offered at least every two years to those aged over 50.  Many other countries across the world either have or are introducing biennial bowel cancer screening programs.

In contrast, we have a pretend national bowel cancer screening program, which offers one-off screening at 50, then a five-year gap to 55, and then a ten-year gap to 65.

These screening intervals are not based on any evidence (how is a 10 yearly screening interval going to prevent the development of cancer?) but are determined instead by the short-sighted political obsession with cost-saving measures to bring the budget back to the magical surplus.

The tragedy is that many lives will be lost unnecessarily in the interim.

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