Strategic Objective 1: Maximising cancer prevention and early detection

2-year goal
Action 1.2.4

Undertake ongoing assessment of the evidence for risk-based, cost-effective population cancer screening.

Early detection of cancer has proven impacts on cancer outcomes through early intervention and treatment. This is enabled through individual risk assessment and tailored cancer screening.

Activities to achieve this 2-year action may include:

  • the identification of opportunities for evidence-based, risk-stratified population cancer screening within current population-based cancer screening programs[104]
  • the identification of opportunities for evidence-based targeted risk screening, or screening of selected high-risk groups, for other tumour types[105]
  • the assessment of clinical and cost-effectiveness of risk-based screening initiatives
  • the ongoing monitoring and evaluation of the benefits and costs of existing and new population cancer screening programs.

In Australia, there are three national, population-based cancer screening programs (for breast,[100] bowel,[101] and cervical[102] cancers). The ongoing assessment of the evidence for population cancer screening initiatives could be broadened to include further population and risk-based screening initiatives. Targeted individual risk assessed screening has the potential to shift the dial for Australians at risk of cancer either due to genetic predisposition or social, cultural, commercial, environmental, and/or behavioural factors (for example, the proposed national lung cancer screening program using low-dose computed tomography scans for people at high risk of lung cancer).

Such initiatives provide a unique opportunity to reduce morbidity and mortality from cancer by focusing on early detection of the disease for those most at risk, and prompt referral for diagnosis and treatment. Ongoing assessment of the clinical and cost-effectiveness of targeted screening initiatives will ensure that overall program benefits outweigh potential harms, and that public funds and resources are spent on the most efficient and cost-effective screening initiatives, based on the best available evidence (Population-Based Screening Framework).[105]

Ongoing assessment of evidence also ensures that the population cancer screening programs are continuously improved, relevant, and aligned to the current evidence base.

Stakeholder Quotes

We need to build the evidence base supporting new screening programs, enabling safe and cost-effective approaches to be considered by the Government.
Public Consultation Submission
We need to build the evidence base supporting new screening programs, enabling safe and cost-effective approaches to be considered by the Government.
Public Consultation Submission
Early detection is one of the most effective long-term strategies for reducing the burden of cancer in Australia by detecting cancer when it is asymptomatic or in its early stages.
Public Consultation Submission
There is significant work underway to reduce the incidence of cancers for which screening does not currently exist…there are significant health gains to be made by exploring new technology and assessing emerging evidence on the efficacy of new approaches
Public Consultation Submission

Implementation Considerations

Aboriginal and Torres Strait Islander people
Adolescents and Young Adults
Children
People from Culturally and Linguistically Diverse (CALD) Backgrounds
People living with Disability
Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, and Asexual (LGBTIQA+) People
People in Lower Socioeconomic Groups
People Living in Rural and Remote Areas
  • Ongoing assessment of risk-based population cancer screening including collaboration, consultation, and co-design with Aboriginal Community Controlled Health Services and networks to identify the greatest risks and concerns for Aboriginal and Torres Strait Islander people.

Aboriginal and Torres Strait Islander people

  • Ongoing assessment of risk-based population cancer screening including collaboration, consultation, and co-design with Aboriginal Community Controlled Health Services and networks to identify the greatest risks and concerns for Aboriginal and Torres Strait Islander people.

Adolescents and Young Adults

  • Risk-based population cancer screening measures to include risk factors unique to adolescents and young people. This may include lifestyle behaviours and environmental factors and screening for genetic risk, including inherited and acquired genetic mutations.

Children

  • Assessment of the considerations unique to children diagnosed with cancer, including the role of genetic testing for inherited and acquired genetic mutations.

People from Culturally and Linguistically Diverse (CALD) Backgrounds

  • Risk-based, cost-effective population cancer screening to include predisposing cancer risk factors that are unique to different members from diverse communities and backgrounds.

People living with Disability

  • Risk-based population cancer screening to include those living with disability and encompass risk factors and considerations associated with comorbid illnesses and chronic disorders.

Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, and Asexual (LGBTIQA+) People

  • Risk-based, cost-effective population cancer screening to include predisposing risks that are unique to members of different groups within the LGBTIQA+ community.
  • Assessment of risk-based screening initiatives to ensure they can be delivered in a manner that is culturally sensitive to the needs, preferences, and considerations of LGBTIQA+ Australians.

People in Lower Socioeconomic Groups

  • Risk-based population cancer screening to include the predisposing risks that are associated with people in lower socioeconomic groups.
  • Assessment of cost-effectiveness to include the burden of costs for individual consumers, not just system-wide cost-effectiveness, to enable future accessibility.

People Living in Rural and Remote Areas

  • Risk-based population cancer screening to include the social and geographical risks that increase the likelihood of developing cancer for people living in rural and remote locations, including reduced access to regular health check-ups and screening, sun exposure, food insecurity, and higher rates of smoking.
  • Assessment of risk-based population screening initiatives to consider scalability into rural and remote areas to ensure equitable access.

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