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Following is a question by the Hon Dr Joseph Lee and a reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (May 16):
Question:
In reply to a Member's question at the Council meeting on March 14 this year, the Secretary for Health, Welfare and Food said that cancer had been the number one killer disease in Hong Kong and there were more than 20 000 new cancer cases in each year from 2002 to 2004, with lung cancer, colorectal cancer, breast cancer, liver cancer and stomach cancer being the five most common types of new cancer cases. In this connection, will the Government inform this Council:
(a) of the support in community medical services currently provided for cancer patients by the Government and the Hospital Authority, whether it will allocate additional resources to this area and provide more proactive community support services (such as giving advice on ways to deal with emotional disturbances) for cancer patients; if it will, of the details; and
(b) whether it will consider providing elderly people aged above 65 with free medical examinations in respect of the above common types of cancer, or providing them with subsidies so that they can receive such examinations in private medical institutions; if it will, of the details and the time for implementation of the relevant policy; if not, the reasons for that?
Reply:
Madam President,
The Government and the Hospital Authority (HA) are committed to providing cancer patients with services to cater for their needs, including, among others, diagnosis, treatment, rehabilitation and hospice care services.
(a) At present, six cancer centres and ten hospitals with hospice or palliative care services under the HA (see Annex) provide holistic and integrated specialist treatment as well as hospice and palliative care services for cancer patients. As regards community support services, the HA provides palliative day care service, with a palliative home care team set up at every hospital cluster to facilitate treatment of some cancer patients in their familiar environment.
The HA adopts a cross-specialty and cross-sector collaborative approach in its palliative care services under which support and care services are rendered by doctors, nurses, medical social workers, clinical psychologists, therapists, religious personnel and volunteers. The scope of services includes controlling the symptoms of the patients, alleviating their pain and soothing their discomfort, and providing healthcare services and emotional and bereavement counselling services to them as well as their families. The HA has established a multi-disciplinary "Central Committee on Palliative Care" to review, coordinate and develop "one-stop" community-based hospice and palliative care services, and to enhance the physical and psychological care for patients and their families and improve their quality of life through the provision of multi-disciplinary services.
In addition, the Community Rehabilitation Network (CRN), which is funded by the Social Welfare Department, provides community rehabilitation services to chronic patients (including cancer patients) and their families and helps them establish mutual help networks, so that they may lead a normal life in the community. There are now a total of six service centres under the CRN. Services include programmes and talks on rehabilitation; support for the activities and developments of patient self-help groups; community education programmes on accepting and caring for chronic patients; etc. Members of the CRN mainly include social workers and allied health workers such as nurses, physiotherapists and occupational therapists. They will seek advice from professionals such as doctors, dieticians, pharmacists and clinical psychologists whenever necessary so as to provide better services for the chronically ill.
(b) Screening refers to the systematic use of simple and effective tests in a healthy population to identify individuals who have a specific disorder but are still asymptomatic, with a view to providing early treatment. Nevertheless, tests are not 100% accurate. If the test result gives a wrong indication of the presence of a condition despite the fact that it does not exist (i.e. "false-positive"), this may cause anxiety, and unnecessary investigation and medical intervention. On the other hand, if the test result fails to detect a condition despite the fact that it is present (i.e. "false-negative"), this may delay the necessary medical treatment.
In deciding whether to introduce a screening programme for a specific disease, the Government needs to consider a number of factors, including the accuracy of the test as well as the effectiveness of the programme in reducing the mortality of that disease. For example, as there is evidence from studies showing that a well-structured cervical screening programme can reduce the incidence and mortality of cervical cancer, the Department of Health (DH) has taken forward a territory-wide cervical screening programme in collaboration with other service providers since 2004.
To achieve cancer prevention in a more effective manner, the Government established the Cancer Coordinating Committee (the Committee) in 2001, which is now chaired by me. The Committee was set up to formulate well-defined strategies and plans, and make recommendations for effective prevention and control of cancer in Hong Kong. In January 2002, a Cancer Expert Working Group on Cancer Prevention and Screening (the Working Group) was set up under the Committee. The Working Group is responsible for reviewing the local and international scientific evidence on cancer prevention and screening, assessing the prevention and screening interventions on cancers practised in Hong Kong and formulating local recommendations for cancer prevention and screening. According to a report released by the Working Group in 2004, there is no sufficient evidence for introducing population-based screening programmes for the five major types of cancer mentioned in the question in Hong Kong. The Government therefore has no plan to provide any subsidies to the elderly for cancer screening. The Government will continue to monitor closely the developments in cancer screening technology.
In fact, apart from screening, a healthy lifestyle is also crucial in the prevention of cancer. As advised by the World Health Organization, at least one-third of cancer cases worldwide can actually be prevented through the adoption of a healthy lifestyle, such as healthy diet, and appropriate amount of physical activity, reducing alcohol consumption, reducing carcinogenic occupational and environmental exposures, and receiving immunisation against hepatitis B virus. In this connection, the DH will continue its efforts to promote healthy lifestyle to the public.
Through different channels, the DH will continue to raise public awareness of various cancer-related symptoms and the importance of early treatment. As part of the efforts, visiting health teams of the Elderly Health Services under the DH will collaborate with other elderly service providers to drive home the above messages among elderly persons and their carers in the community.
Ends/Wednesday, May 16, 2007
Issued at HKT 13:06
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