LCQ18: Assisting women in preventing gynaecological diseases
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Question:
There are views pointing out that most gynaecological diseases (such as cervical cancer, breast cancer and ovarian cancer) can be detected early by way of regular gynaecological check-ups. However, the relevant gynaecological check-up services currently offered in the community come in a great variety and charge high fees that members of the public in general can hardly afford. In this connection, will the Government inform this Council:
(1) whether it has conducted a survey on the ages of incidence of patients suffering from cervical cancer, breast cancer and ovarian cancer; if so, of the details, including whether there is a downward trend in the age profiles of such patients, and the measures in place to prevent such trend from continuing; if not, the reasons for that;
(2) whether it will roll out schemes to provide women with subsidies for receiving gynaecological check-ups, so that they can detect the diseases and receive treatments as early as possible; if so, of the details (including the expected number of beneficiaries); if not, the reasons for that, and whether other schemes will be introduced to assist women in receiving gynaecological check-ups;
(3) given that some studies have found that human papillomavirus (HPV) vaccine is effective in preventing cervical cancer as well as other cancers or diseases caused by the infection of HPV, and the Government is currently providing HPV vaccination service for eligible female primary school students, of the implementation progress of the service; and
(4) whether it will consider creating a webpage and a mobile application to provide women with information on gynaecological diseases, including examination methods as well as the gynaecological check-up services offered and the fees charged by the relevant organisations; if so, of the details and timetable; if not, the reasons for that?
Reply:
President:
In consultation with the Department of Health (DH) and the Hospital Authority (HA), the reply to the various parts of the question raised by Hon Dominic Lee is as follows:
(1) According to the statistics collected by the Hong Kong Cancer Registry under the DH, there was no downward trend in the median age at diagnosis for patients with breast cancer, cervical cancer, ovarian cancer and corpus uteri cancer between 2010 and 2019. There is also no concrete evidence indicating the trend of persons suffering from these cancers at a younger age. Relevant figures are listed below:
| Year (Note 1) | Breast Cancer | Cervical cancer | Ovarian and Peritoneal cancer (Note 2) | Corpus uteri cancer | ||||
| No. of new case | Median age (years) | No. of new case | Median age (years) | No. of new case | Median age (years) | No. of new case | Median age (years) | |
| 2010 | 3 014 | 53 | 400 | 53 | 468 | 51 | 713 | 54 |
| 2011 | 3 419 | 54 | 391 | 53 | 520 | 51 | 685 | 54 |
| 2012 | 3 508 | 54 | 457 | 52 | 531 | 51 | 810 | 55 |
| 2013 | 3 524 | 54 | 503 | 53 | 526 | 50 | 942 | 55 |
| 2014 | 3 868 | 55 | 472 | 52.5 | 576 | 51 | 997 | 54 |
| 2015 | 3 900 | 56 | 500 | 54 | 578 | 52 | 978 | 55 |
| 2016 | 4 108 | 56 | 510 | 55 | 598 | 53 | 1 050 | 56 |
| 2017 | 4 373 | 57 | 516 | 54 | 651 | 52 | 1 076 | 55 |
| 2018 | 4 618 | 57 | 582 | 54 | 664 | 54 | 1 165 | 55 |
| 2019 | 4 761 | 58 | 520 | 55 | 732 | 54 | 1 198 | 57 |
Note 2: Starting from 2018, "Ovary and Peritoneal cancer" includes ovarian, fallopian tube, and primary peritoneal cancers. Hence comparison with figures in previous years which used a slightly different counting rule is not directly applicable.
(2) The Government has been launching various schemes to subsidise women to undergo gynaecological examinations. The Family Health Service of the DH provides subsidised Woman Health Service (WHS) for women aged 64 or below at the three Woman Health Centres (WHCs) and ten Maternal and Child Health Centres (MCHCs). The scope of service includes health education, assessment, counselling, as well as investigations as appropriate (including mammography (MMG) screening and breast ultrasound scanning). In 2021, the total attendance of WHS was 5 500 (Note 3).
Cancer prevention and control is an important part of women's health. The Government has been promoting evidence-based cancer screening as a tool for secondary prevention in accordance to the Hong Kong Cancer Strategy. The screening aims to detect cancers early or to identify precancerous disease in apparently healthy (asymptomatic) individuals so that treatment can be carried out more effectively. The Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) has so far formulated relevant recommendations on screening of nine cancers in Hong Kong, including cervical, breast and ovarian cancers.
Based on the recommendations of the CEWG, the Government launched the territory-wide Cervical Screening Programme (CSP). Eligible women may receive subsidised cervical screening service through the WHCs and MCHCs under the DH. In 2021, the number of attendance of cervical screening service at MCHCs was 53 700.
In addition, the Government also launched the risk-based Breast Cancer Screening Pilot Programme. The Pilot Programme commenced at the three WHCs and 18 Elderly Health Centres under the DH in September and December 2021 respectively, providing breast cancer screening services for eligible women aged between 44 and 69. Women identified to be at increased risk of breast cancer by the breast cancer risk assessment tool will be referred by the DH to the outsourced imaging centres for MMG screening and supplementary breast ultrasound scanning. As at March 31, 2022, 5 900 eligible women received breast cancer risk assessment. Among them, 2 000 were referred for MMG screening (including breast ultrasound scanning as needed).
For cervical screening and breast cancer screening provided by the DH, fees will be waived for women who are in receipt of the Comprehensive Social Security Assistance, holders of waivers of medical charges under the Medical Fee Waiving Mechanism of Public Hospitals and Clinics, or Level 0 Voucher Holders of the Pilot Scheme on Residential Care Service Voucher for the Elderly.
At the primary healthcare level, District Health Centres (DHCs) are committed to promoting disease prevention through various means and channels. Among others, DHCs provide health education on topics covering women's health with a view to enhancing the awareness of citizens on self-health management and disease prevention, such as breast health awareness, osteoporosis, cervical cancer prevention, smoking cessation counselling and healthy diet seminars, etc.
At the same time, DHCs have been actively cooperating with the Government's cancer strategy in providing its basic health risk factors assessment for the public by including the identification of cancer-related risk factors. For members of the public who are eligible to participate in the CSP, Colorectal Cancer Screening Programme or Breast Cancer Screening Pilot Programme, DHCs will provide them with professional guidance, coordination and referral to medical practitioners who have participated in various screening programmes for screening with a view to offering necessary treatment to them as early as possible. Furthermore, DHCs also target their promotion efforts on preventing cancer-related risk factors, including unhealthy diet, lack of exercise, alcohol consumption, smoking, etc. If members of the public are identified with these risk factors, DHCs will provide wellness programmes to assist them in managing risk factors, staying healthy and reducing the risk of cancer.
In addition, DHCs are also exploring to provide further community support for cancer patients. For example, the Breast Cancer Survivorship Programme has been piloted at Sham Shui Po DHC to provide community support for patients recovered from breast cancer, including exercise, healthy diet and social psychosocial support, etc., so that they can take better care of their own health.
(3) Starting from the 2019/20 school year, the DH has rolled out the human papillomavirus (HPV) vaccination programme to Primary five and six female students under the Hong Kong Childhood Immunisation Programme as a public health strategy to prevent cervical cancer. The first dose of HPV vaccine will be given to Primary five female students at their schools, and the second dose of the recommended vaccine schedule will be given to the girls when they reach Primary six in the following school year. In 2020/21 school year (as at end of December last year), the vaccination rates of the first dose and the second dose of Primary five and six female students were 88 per cent and 86 per cent respectively.
(4) Currently, the DH has set up a webpage, providing relevant health information on women's health (www.fhs.gov.hk/english/health_info/class_topic/ct_woman_health/ct_woman_health.html). Furthermore, the Cancer Online Resource Hub (www.cancer.gov.hk/en/index.html) was launched in July 2020 to serve as a database of cancer-related information and to provide the public with accurate and reliable health information relating to cancer. The Government has also set up a thematic website for the CSP (www.cervicalscreening.gov.hk), through which the public can obtain the information about the CSP, including inspection methods and details.
Note 3: In view of the COVID-19 epidemic situation, the WHS was suspended from February 2020 onwards. Subsequently, three WHCs have resumed providing WHS since September 6, 2021.
Ends/Wednesday, July 6, 2022
Issued at HKT 17:10
Issued at HKT 17:10
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