CHAPEL HILL, N.C. - A new finding by a UNC scientist and Australian colleagues demonstrates that the rising cost of cancer care is compelling Westernized countries to quickly adopt screening programs.
Michael Pignone, MD, MPH, is co-author of a study published in the February 21, 2011 Medical Journal of Australia about colon cancer screening in that country. Pignone, who led the study, and his fellow scientists from Australia report that implementing a biennial (every two years) colorectal cancer screening for Australians ages 50-74 would reduce colon cancer deaths by 15-25 percent annually and prevent 300-500 deaths per year from the disease. The Medical Journal of Australia is a publication of the Australian Medical Association .
Pignone is professor of medicine, chief of the division of general medicine and epidemiology, and a member of UNC Lineberger Comprehensive Cancer Center.
Australia has a population of 23 million people, about twice the size of North Carolina, and one of the highest incidences of colon cancer in the world: In 2010 the Cancer Council of Australia estimated that 14,700 Australians would be diagnosed with colorectal cancer and approximately 3,700 would die from their disease.
At present, the Australian government has implemented only a limited colorectal cancer screening program, with one-time fecal occult blood test (FOBT) screening for those aged 50, 55 and 65 years. The team analyzed existing economic models from Australia and performed additional modeling themselves to determine the costs and cost-effectiveness of full implementation of biennial FOBT screening for the 5 million adults in Australia aged 50-74 years.
Pignone says, “Regular colorectal cancer screening means diagnosing cancers at an earlier and more easily treated stage, thus saving lives and dollars. And, based on savings from reduced treatment costs, we estimate that implementation of a full program could be achieved with a modest additional investment.”
Senior author James B. St. John, MD, says, “ Right now, Australians spend over $750 million caring for patients with colorectal cancers, and with treatment costs rising each year, a biennial colorectal cancer screening program for Australians aged 50-74 should be seriously considered.
“The actual additional expenditure required is likely to be less than $50 million per year. Full implementation of colorectal cancer screening would bring spending in this program up to a level similar to that for other cancer screening program such as those for breast and cervical cancers.”
St. John is associate professor and honorary principal fellow in the department of medicine at the University of Melbourne, Melbourne, VIC, and honorary senior associate of the Cancer Council Victoria, Melbourne, VIC.
Pignone completed the work as a recipient of a Packer Policy Fellowship from the Australian Department of Health and Ageing. Pignone is an international expert on colorectal cancer screening and has participated in reviews of colon cancer screening practices, the results of which have been used by groups such as the US Preventive Services Task Force and the Institute of Medicine to help develop screening guidelines.
In the US in 2010, the American Cancer Society estimated that 142,570 Americans would be diagnosed with colorectal cancers and that 51,370 people would die from their disease.
Additional authors are Kathy L. Flitcroft, Kirsten Howard, Lyndal J. Trevena, and Glen P. Salkeld, all from the University of Sydney School of Public Health, Sydney, NSW.
Pignone will use his Australian research experience to inform a new project, funded by the University Cancer Research Fund. He and colleagues in the US and Australia will compare how people in each country differ in terms of their values about the benefits and downsides of prostate and colorectal cancer screening. In doing so, they hope to learn whether citizens of each country have similar or different values about screening, and then examine how such values influence the design and utilization of cancer screening programs. The University Cancer Research Fund was created by the North Carolina General Assembly in 2007. The University Cancer Research Fund’s mission is to save lives and reduce suffering from cancer in North Carolina and beyond through discovery of the causes and course of cancer, innovation in detection, prevention and treatment and delivery of improved care, screening and prevention.
Read Cancer Council Australia’s related news release .