LCQ5: Prevention of cancers and cancer treatment
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Question:
The Government launched the Colorectal Cancer Screening Pilot Programme (the Pilot Programme) in September last year to subsidise people of specific age groups for receiving colorectal cancer screening. In addition, the Hong Kong Cancer Fund has collaborated with the Hospital Authority (HA) in setting up Cancer Patient Resource Centres in some public hospitals to offer resources and assistance to cancer patients. HA has also launched the cancer case manager programme, under which experienced nurses are assigned as case managers specifically tasked with the responsibility of following up confirmed cancer patients. Regarding the prevention of cancers and provision of treatment and support for cancer patients, will the Government inform this Council:
(1) of the number of participants in the Pilot Programme since its launch; among such participants, the numbers and percentages of those diagnosed with colorectal cancer, broken down by age group (i.e. 45 to 50, 51 to 55 and 56 to 60); the number of primary care doctors currently engaged in the Pilot Programme, and the average number of persons provided with examination services by each of those doctors in a month;
(2) whether it knows the current waiting time for patients with the cancers listed in the table below to receive their first treatment in public hospitals (set out in the table below); whether HA has plans to shorten such waiting time and draw up relevant performance pledges; if HA does, of the details; if not, the reasons for that;
| Type of cancer | Waiting time | |||||
| 30-59 days | 60-89 days | 90-119 days | 120-149 days | 150-179 days | 180 days or above | |
| Colorectal cancer | ||||||
| Lung cancer | ||||||
| Breast cancer | ||||||
| Liver cancer | ||||||
| Prostate cancer | ||||||
| Corpus uteri cancer | ||||||
| Nasopharyngeal cancer | ||||||
| Thyroid cancer | ||||||
| Stomach cancer | ||||||
| Non-Hodgkin lymphoma cancer | ||||||
(3) whether it knows the number of patients who received services in various Cancer Patient Resource Centres, and the percentage of that number in the total number of cancer patients in public hospitals in the relevant year, in each of the past three years; whether such centres only serve patients of specific types of cancer; if so, of the details;
(4) whether it knows if HA has reviewed the efficacy of the cancer case manager programme; if HA has, of the outcome (including the relevant data); of the number of patients serviced by the programme, and the percentage of that number in the total number of cancer patients in public hospitals in the relevant year, in each of the past two years; the number of cases that each case manager needs to handle concurrently at present;
(5) whether it has plans to provide the public with more information about caring for cancer patients; if so, of the details; if not, the reasons for that; and
(6) whether it knows the number of cancer patients who received palliative care services in public hospitals in each of the past five years (broken down by type of service); whether HA has partnered with any private healthcare institution at present to provide such services for patients so as to reduce the pressure on public hospitals; if HA has, of the details; if not, the reasons for that?
Reply:
President,
(1) The Government launched the three-year Colorectal Cancer Screening Pilot Programme (Pilot Programme) on September 28, 2016 to subsidise in phases asymptomatic Hong Kong residents born from 1946 to 1955 to undergo colorectal cancer screening tests. The aim of the Pilot Programme is to help identify those people who are more likely to develop colorectal cancer or who already have the disease, so that treatment can start earlier to improve the chances of a cure. According to the screening procedures of the Pilot Programme, a participant will first undergo the government-subsidised Faecal Immunochemical Test (FIT) by an enrolled primary care doctor (PCD). If the FIT result is positive, the PCD will, according to the participant's choice, refer him/her to undergo a government-subsidised colonoscopy examination by an enrolled colonoscopy specialist (CS) to find out the cause of occult blood in their stool.
The Pilot Programme is conducted in three phases. The first phase was launched on September 28, 2016 with target participants born from 1946 to 1948. The second phase was launched on February 27, 2017 with its coverage extended to those born from 1946 to 1951. As at March 31, 2017, 600 PCDs had joined and provided government-subsidised FIT service for about 24 800 participants under the Pilot Programme. On average, each enrolled PCD had provided FIT service for about 40 participants. In addition, 136 CSs had joined the Pilot Programme to provide government-subsidised colonoscopy examination service for participants with a positive FIT result. As at March 31, 2017, about 3 200 participants were found to have a positive FIT result. Excluding those who selected to undergo colonoscopy examination service at public hospitals or other private healthcare institutions, each enrolled CS provided colonoscopy examination service for about 20 FIT positive participants.
As the Pilot Programme has been implemented for just half a year and covering only those born from 1946 to 1951, the Department of Health cannot provide the figures and percentage of diagnosed cases by age groups for the time being. The Government will decide on future service arrangements after reviewing the effectiveness of the Pilot Programme.
(2) As the diagnosis and treatment process of individual cancer patients vary depending on the types of cancer and their clinical symptoms, the Hospital Authority (HA) does not have a standardised approach to assess the waiting time for different cancer diseases.
The HA reviews regularly the waiting times for patients with colorectal cancer, breast cancer and nasopharyngeal cancer respectively to receive their first treatment after diagnosis. Between July 2015 and June 2016, the waiting times at the 90th percentile (note) for patients with colorectal cancer, breast cancer and nasopharyngeal cancer respectively to receive their first treatment after diagnosis were 69 days, 64 days and 53 days respectively.
The HA has planned to enhance its cancer services in 2017-18 through, for example, increasing the service capacity of chemotherapy and radiotherapy.
(3) The HA has partnered with the Hong Kong Cancer Fund to establish Cancer Patient Resource Centres (CPRCs) in Queen Mary Hospital, Tuen Mun Hospital, Pamela Youde Nethersole Eastern Hospital, Prince of Wales Hospital, Princess Margaret Hospital, Queen Elizabeth Hospital and United Christian Hospital. The CPRCs provide free resources and services for cancer patients, including a cancer information library, professional counselling services, rehabilitation workshops, peer support activities, services which seek to provide information and assistance to newly-diagnosed patients, as well as rehabilitation or palliative support for those who are going through other stages of the cancer journey. Some activities organised by the CPRCs are funded by the Hong Kong Cancer Fund. The HA does not maintain statistics on the usage of the CPRCs.
(4) The HA has implemented the cancer case manager programme in phases since 2010-11 for patients with complex breast cancer or colorectal cancer. Under the programme, the cancer case managers act as the single contact persons between these patients and the doctors. The programme was extended to all the clusters in 2014-15. There are currently 21 cancer case mangers serving those cancer patients participating in the programme. The number of cancer patients benefitting from the programme in the past two years are as follows:
| Year* | Number of cancer patients benefitting from the cancer case manager programme |
| 2014-15 | 4 558 |
| 2015-16 | 5 837 |
In 2016, the HA conducted a patient satisfaction survey on the cancer manager programme, the results of which showed that patients were satisfied with the programme. Another survey on the quality of life conducted at the same time also showed that patients covered by the programme were satisfied with their quality of life.
(5) The HA provides comprehensive disease information for patients suffering from chronic diseases (including cancer patients) and their families through the "Smart Patient Website", a one-stop information hub that helps strengthen their ability in disease management. The "Cancer in Focus" section of the website offers cancer patients disease information and self-care tips.
(6) The HA provides appropriate palliative care services for terminally-ill patients (including cancer patients and patients with organ failure) and their families according to the principle of "providing holistic care for patients". Such services are delivered in an integrated mode through multi-disciplinary palliative care teams comprising doctors, nurses, medical social workers, clinical psychologists, physiotherapists and occupational therapists.
At present, palliative care services, including in-patient service, out-patient service, day care service, home care service, bereavement counselling, are provided in all seven clusters of the HA. The statistics on the utilisation of each type of palliative care services from 2012-13 to 2016-17 (as at December 31, 2016) are set out at Annex.
The HA will continue to review the demands for various medical services and plan its services, including various types of palliative care services, according to factors such as population growth and changes, advancement of medical technology and healthcare manpower. Improvements will be made while ensuring efficient use of resources with a view to meeting the overall public demand.
Currently, the HA does not have any plans for public-private partnership in the provision of palliative care services for cancer patients.
Note: The 90th percentile waiting time refers to the number of days between the date when a case is diagnosed with cancer after pathological examination and the date when the patient receives first treatment. The waiting time of 90 per cent of such cases is shorter than the value indicated.
Ends/Wednesday, April 12, 2017
Issued at HKT 17:40
Issued at HKT 17:40
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