National Cancer Prevention Policy - Tobacco Control Supersite

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An Australian review of the benefits of screening women aged 40 to 49 years concluded that there is less benefit in screening these women. The benefit is greater for those at the older end of the age bracket, and for those with a strong family history of breast cancer. The benefit of screening women aged 40 to 49 years is estimated at approximately onethird of that of women aged 50 to 69 years (Irwig et al. 1997). BreastScreen Australia policy states: BreastScreen Australia selects women for screening on the basis of age alone. Women aged 40 years and above are eligible. Recruitment strategies will be targeted at women aged 50–69 years. The age for screening will be monitored and reviewed as new data becomes available (BreastScreen Australia 2004a). With increasing life expectancy, the value of screening women over 70 years has also come under investigation. Barratt et al. (2002) estimate that the benefit of screening women aged 70 to 79 years to be about 40% to 72% of that achieved in women aged 50 to 69 years; this declines further with increasing age and when quality-of-life adjustment is made. They estimate that extending screening to women aged 70 to 79 years is relatively cost-effective and similar to the cost-effectiveness of extending screening to women aged 40 to 49 years. The authors, however, also comment that the estimation of benefits, harms and costs would be improved with data—now lacking—from randomised trials in the appropriate age group. Aims The Cancer Council endorses the major aims of the BreastScreen Australia program (AIHW, BreastScreen & NCSP 1999): • • • • • • to ensure that the program is implemented in such a way that significant reductions can be achieved in morbidity and mortality attributable to breast cancer to maximise the early detection of breast cancer in the target population to ensure that screening for breast cancer in Australia is provided in dedicated accredited screening and assessment services as part of the BreastScreen Australia program to ensure equitable access for women aged 50–69 years to the program to ensure that services are acceptable and appropriate to the needs of the eligible population to achieve high standards of program management, service delivery, monitoring and evaluation and accountability (BreastScreen Australia 2004b). National Cancer Prevention Policy 2007 – 09 133 B r e a s t c a n c e r
What we want to achieve How The Cancer Council Australia and its members (the state and territory cancer councils) will do this A 70% two-yearly participation rate in the national program by women in the target group (50–69 years) and access on request to the program for women aged 40–49 years and 70 years or more Referral to appropriate treatment services and collection of information about the outcome of treatment Sufficient workforce capacity to ensure the delivery of a best practice screening program to the target population (women 50–69) Timely evaluation of new technologies National evaluation of BreastScreen performance, capacity and policy issues by 2008 134 National Section Two: Cancer Screening Prevention to detect Policy cancer 2004 – early 06 Maintain and support education programs to raise awareness in the community and among health professionals to promote informed participation of women aged 50–69 years in breast cancer screening Advocate for government support, including adequate funding, to ensure targets for participation are met, while maintaining a focus on equity and access for women Priority should be given to maximising the participation of Australian Aboriginal and Torres Strait Islander women and women of culturally and linguistically diverse backgrounds Recognising that many women have mammograms outside BreastScreen, advocate for integration of screening of all asymptomatic women aged 50–69 years into the BreastScreen Australia program Recognising the importance of providing consistent high-quality care for women diagnosed with breast cancer in Australia: • support or advocate for examination of the extent to which women diagnosed in the screening program are being treated in accordance with the NHMRC Clinical practice guidelines for the management of early breast cancer (2001), Management of advanced breast cancer (2001) and Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer (2003) Recognising the importance of informed consumer involvement in all aspects of breast cancer screening, diagnosis and management, advocate for active roles for consumers within peak breast cancer bodies in Australia Recognising the implications in the short and longer term of radiography and radiology workforce constraints for BreastScreen Australia, advocate for increased funding to provide additional places for the training of radiographers and radiologists Monitor development of relevant new technologies, (such as digital mammography and MRI), advocate for rapid evaluation of their relevance for screening and adoption of those that are positively evaluated Support and contribute to national evaluation of the following areas: • reductions in breast cancer mortality due to screening, risks associated with screening, program governance and management, performance trends, accreditation system • workforce, new technologies and capacity issues • policy issues such as the appropriate target age range, screening interval, and screening of women at higher risk or those who present with symptoms
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National Cancer Prevention Policy 2
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The Cancer Council Australia Member
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Overweight and obesity 86 Introduct
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A b b r e v i a t i o n s AACR Aust
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T h e N a t i o n a l C a n c e r P
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increase their understanding of man
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T o b a c c o Introduction 12 Secti
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Figure 1.1 Number of Australians wh
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(16.3%) continues the trends observ
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in the longer-term future, when hea
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Tobacco products are among the top
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In 2007, given estimated costs of $
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improved regulation, by collectivel
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Tobacco control strategy for Aborig
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Australian National Tobacco Strateg
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Regulation of products Possible reg
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• • parents/carers and children
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Australia in partnership with a num
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What needs to be achieved How The C
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——— 2005. 2004 National Drug
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Schofield PE, Borland R, Hill DJ, P
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In adult life, recreational (interm
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ehaviours as a result of public edu
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Screening for melanoma There is ins
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What needs to be achieved How The C
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Autier P 2004. Issues about solaria
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N u t r i t i o n Introduction 52 S
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Table 1.4 Conclusions of the major
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It may be possible that different t
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Table 1.5 Current trends in consump
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key stakeholders (Sorensen et al. 1
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A large scale randomised controlled
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• The International Union Against
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References Nutrition Agency for Hea
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Kushi L & Giovannucci E 2002. Dieta
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Strategic Inter-Governmental Nutrit
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How physical activity is measured U
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There is consistent epidemiological
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• • Moderate-intensity physical
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to help them achieve greater and mo
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Populations Aboriginal and Torres S
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Page 85 and 86: McTiernan A, Kooperberg C, White E,
Page 87 and 88: O v e r w e i g h t a n d o b e s i
Page 89 and 90: Table 1.9 Proportion of cancer attr
Page 91 and 92: were $107.3 million in 2005, with 7
Page 93 and 94: Obese children have a 25% to 50% ch
Page 95 and 96: Table 1.10 Summary of the strengths
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Page 101 and 102: What needs to be achieved How The C
Page 103 and 104: References Overweight and obesity A
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Page 107 and 108: ——— 2004. SNAP: A population
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Page 111 and 112: How the amount of disease caused by
Page 113 and 114: The challenge Adults Alcohol is a s
Page 115 and 116: and healthy drinking cultures in Au
Page 117 and 118: ook’) (RACGP 2006) assists in dev
Page 119 and 120: English DR, Holman CDJ, Milne E, Hu
Page 122 and 123: Section Two: Screening to detect ca
Page 124 and 125: early detection improves health out
Page 126 and 127: false positive faecal occult blood
Page 128 and 129: 1987, compared to 51.3 deaths per 1
Page 130 and 131: Breast self-examination Breast self
Page 132 and 133: a significant proportion of women a
Page 136 and 137: References Breast cancer Australian
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Page 144 and 145: Recruitment Women in the target age
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Page 148 and 149: could focus on: how to use this tim
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Page 154 and 155: likely to do so if reinvited, espec
Page 156 and 157: What we want to achieve How The Can
Page 158 and 159: P, Sivak MV & Butler H 2004. Comput
Page 160 and 161: Scholefield JH, Moss S, Sufi F, Man
Page 162 and 163: M e l a n o m a Melanoma in Austral
Page 164 and 165: Would screening be of benefit at th
Page 166 and 167: P r o s t a t e c a n c e r Cancer
Page 168 and 169: have lower levels of free PSA than
Page 170 and 171: • • a monitoring mechanism be p
Page 172 and 173: ecause surgical patients are usuall
Page 174 and 175: Klein EA 2004. Selenium and vitamin
Page 176 and 177: Section Three: Immunisation www.can
Page 178 and 179: epithelial carcinomas of the bladde
Page 180 and 181: The challenge Stigmatisation of cer
Page 182 and 183: The goals of a therapeutic vaccine
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Brinkman JA, Caffrey AS, Muderspach
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Victorian Cervical Cytology Registr
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Chronic hepatitis B infection occur
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Global Globally, an estimated two t
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The rise in HCC is thought to be as
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• • • • • • • • •
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The policy context The bleak outcom
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Aims What needs to be achieved How
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Chen DS 2005. Long-term protection
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Williams A 2002. Reduction in the h
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Authors Dr Cleola Anderiesz BSc (Ho
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Associate Professor John Kelly MDBS
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A alcohol 107 - 119 aims of The Can
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east cancer (post-menopause) 87, 88
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The National Cancer Prevention Poli
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