A cancer control system that seeks to eliminate racism, proactively reduces cancer risk and supports all Australians to access personalised, evidence-based cancer prevention and early detection strategies.
Cancer is the leading cause of disease burden in Australia, and almost half (42%) of the cancer burden is attributable to modifiable risk factors.[1] Understanding and addressing the risk factors associated with cancer helps to reduce the chance of developing cancer. Additionally, participation in cancer screening programs[95] can increase the likelihood of preventing cancer or detecting cancer early, enabling less extensive treatments, decreases in mortality, and increased survival.[1]
The Australian Cancer Plan (the Plan) complements and strengthens the implementation strategies in the National Preventive Health Strategy 2021–2030.[18]
Priority areas for action in the Plan to maximise cancer prevention and early detection include:
A cancer control system that seeks to eliminate racism, proactively reduces cancer risk and supports all Australians to access personalised, evidence-based cancer prevention and early detection strategies.
In achieving this ambition, Australia will remain at the global forefront of evidence-based cancer prevention and cancer screening strategies.
Most ambitiously, racism and discrimination as a major barrier to equity of access to cancer prevention and early detection will be eliminated.
All Australians will be supported and encouraged to reduce their cancer risk, particularly by addressing modifiable cancer risks such as smoking, being overweight or obese, alcohol use, diet, sun exposure and physical inactivity.
Participation in Australia’s current national cancer screening programs (BreastScreen Australia,[100] the National Bowel Cancer Screening Program,[101] and the National Cervical Screening Program[102]) will be increased. Driven by evidence and data, new targeted screening programs and targeted or personalised screening and prevention strategies will be available to those who need them.
Access to personalised prevention and early detection will be tailored to a person’s individual health status, health risks, and social and cultural needs. Culturally safe approaches to prevention and early detection will improve access and participation by priority population groups with poorer health and cancer outcomes.
Access to culturally safe prevention and screening approaches to reduce cancer risk is improved, and evidence-based and personalised cancer risk assessment strategies are identified.
In achieving this 2-year goal, access to culturally safe prevention and early detection strategies will be strengthened through co-design and tailored to a range of settings.
Equity of access to culturally safe prevention and early detection strategies will be enhanced by understanding the broader impact of social, cultural, commercial and environmental determinants of health on cancer outcomes for priority populations.
Ongoing assessment of the evidence will inform personalised cancer risk assessment approaches.
Access to culturally safe prevention and screening approaches to reduce cancer risk is improved, and evidence-based and personalised cancer risk assessment strategies are identified.
In achieving this 2-year goal, access to culturally safe prevention and early detection strategies will be strengthened through co-design and tailored to a range of settings.
Equity of access to culturally safe prevention and early detection strategies will be enhanced by understanding the broader impact of social, cultural, commercial and environmental determinants of health on cancer outcomes for priority populations.
Ongoing assessment of the evidence will inform personalised cancer risk assessment approaches.
Culturally safe prevention and screening approaches to reduce cancer risk are embedded, and evidence-based and personalised cancer prevention and early detection strategies are incorporated into standard of care.
In achieving this 5-year goal, culturally safe programs to reduce cancer risk will be embedded into standard practice.
System-wide issues which influence access to prevention and early detection will be identified and addressed, including a focus on social, cultural, commercial and environmental determinants of health.
Individuals will be supported to access cancer prevention and early detection approaches that are personalised to their specific risks (including genomic risk) and that take into consideration their health literacy and social and cultural needs.
Stakeholders emphasised the role for the Plan in increasing awareness, education, and support to address social, cultural, commercial and environmental determinants of health and modifiable lifestyle factors that contribute to an increased risk of developing cancers. This includes the role of the Plan in complementing the strategies in the National Preventive Health Strategy 2021–2030[18] and state-based cancer plans.
The need to support increased participation in national cancer screening programs was expressed, and it was noted that all people need access to cancer prevention and early detection programs that are culturally safe and inclusive. The impact of existing screening programs could be increased by adopting more risk-stratified approaches, where evidence is available, improving the experience of screening participation, and tailoring consumer engagement approaches. Stakeholders supported expanding screening programs to a broader range of cancers, including by leveraging new technology and tools.
Stakeholders called for greater efforts to detect symptoms and signs of cancers earlier, such as through opportunistic testing, risk recognition, and symptom awareness.
To improve cancer outcomes for Aboriginal and Torres Strait Islander people, stakeholders identified that it is critical to address the racism and discrimination experienced by Aboriginal and Torres Strait Islander people across the health system. Addressing the cultural determinants of health and the social determinants of health and providing culturally safe and appropriate screening approaches and early detection programs, including those which take into consideration broader family and community, could further improve cancer outcomes for Aboriginal and Torres Strait Islander people.
Connecting with Aboriginal and Torres Strait Islander communities to maximise cancer prevention among Aboriginal and Torres Strait Islander people was considered important. Ways to connect with Aboriginal and Torres Strait Islander communities include engaging with Aboriginal and/or Torres Strait Islander Health Services, organisations and health professionals.
To improve cancer outcomes for Aboriginal and Torres Strait Islander people, stakeholders identified that it is critical to address the racism and discrimination experienced by Aboriginal and Torres Strait Islander people across the health system. Addressing the cultural determinants of health and the social determinants of health and providing culturally safe and appropriate screening approaches and early detection programs, including those which take into consideration broader family and community, could further improve cancer outcomes for Aboriginal and Torres Strait Islander people.
Connecting with Aboriginal and Torres Strait Islander communities to maximise cancer prevention among Aboriginal and Torres Strait Islander people was considered important. Ways to connect with Aboriginal and Torres Strait Islander communities include engaging with Aboriginal and/or Torres Strait Islander Health Services, organisations and health professionals.
Comparatively fewer cancer services leads to limited access to cancer screening and prevention programs for people living in rural and remote areas. Stakeholders identified that greater accessibility of cancer screening and prevention services is needed to increase engagement in these services for people living in rural and remote areas.
LGBTIQA+ people are at greater risk of specific cancers including breast and cervical cancers, but participation in cancer screening programs is low among this community.
Stakeholders proposed that LGBTIQA+ inclusivity, visibility, and knowledge in cancer prevention and screening programs (including ensuring transgender people are invited to access relevant targeted programs) is needed to increase LGBTIQA+ peoples’ participation in these programs.
Improved communication about cancer prevention with individuals from diverse backgrounds was identified. This included ensuring accessible and culturally appropriate communication about the role of cancer screening in preventing cancers and identifying cancers early.
Training health workers in cultural safety and communication will support engagement with people from diverse backgrounds in cancer screening programs and promote understanding of cancer prevention and early detection.
People living with disability often experience barriers to accessing preventive care. Stakeholders advised that communications and resources relating to preventive health are not always accessible: for example, they should be spoken and written in plain English.
People in lower socioeconomic groups were considered to have poorer health outcomes because they may have limited access to physical activity programs or balanced nutrition options.
Additionally, out-of-pocket costs relating to accessing care or travel for cancer prevention and early detection services present additional challenges.
Stakeholders noted that people with a mental illness may receive a delayed cancer diagnosis due to challenges in accessing screening and prevention programs.
Personal experiences of ageism and discrimination in the health sector can be a significant barrier to older people accessing cancer screening and prevention programs.
Stakeholders identified the need for greater access to targeted screening programs for adolescents and young people who are at higher risk of developing cancer due to genetic predisposition and other factors.
Children experience delayed cancer diagnoses, in part because they have difficulty communicating symptoms. Parents and carers report feelings of guilt when it takes multiple appointments before symptoms are appropriately investigated and diagnosis occurs. Delays in diagnosis are exacerbated for children within other priority population groups, including Aboriginal and Torres Strait Islander children, children from diverse backgrounds, children in lower socioeconomic groups, and children living in rural and remote areas.