Replies to LegCo questions
LCQ3: Services for cancer patients
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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