Budget delivers improved cervical and breast cancer screening

 Budget delivers improved cervical and breast cancer screening
Budget 2021 funds a more effective cervical screening test to help reduce cervical cancer rates·         A new breast screening system that can proactively identify and enrol eligible women to reach 271,000 more people who aren’t currently in the programme.Budget 2021 delivers a better cervical screening test and a major upgrade of the breast cancer screening system to reduce the number of people who die from the two diseases.“We are able to invest in and implement changes in health that will deliver for all New Zealanders thanks to our economy performing better than forecast because of the Government’s successful management of COVID-19,” Health Minister Andrew Little said, in a pre-Budget announcement.“This is a recovery budget. The Budget will continue to focus on securing our recovery while making investments that improve the lives of New Zealanders.“In the last three Budgets, we have made significant investments in health including delivering the biggest funding boost to maternity care in a decade. Our investment today builds on this so we can continue to address some of the country’s long-standing issues,” Andrew Little said.“Every year, about 160 women develop cervical cancer and about 50 die from it. This is a tragedy as almost all cases are preventable or can be treated if they’re found at an early stage,” Associate Health Minister (Women’s Health) Dr Ayesha Verrall said.“While our National Cervical Screening Programme has reduced incidence and death rates for cervical cancer by more than half since 1990, we know that only 61 percent of eligible wāhine Māori access it. There are many reasons for this including the time, cost and whakamā associated with taking the smear test.“The persistent inequities around cervical cancer has been one of the long-standing issues in women’s health.“That’s why Budget 21’s investment of up to $53 million to complete the design of and implement a new test for humanpapillomavirus (HPV), the cause of 99 percent of cervical cancers will make a real difference.“The new test, which will replace the current smear test for the 1.4 million eligible women aged 25-69 years old, is a simple and quick swab that women can choose to do themselves. This will help to reduce the barriers to getting screened.“Clinical modelling predicts the move to HPV screening will prevent about 400 additional cervical cancers over 17 years and will save around 138 additional lives. Around a third of the cases prevented and lives saved will be wāhine Māori.“HPV testing, which is in place in Australia, the United Kingdom, Ireland and several other European countries, is also shown to be more effective so women who test negative only need to be screened every five years, not every three years as is currently the case.“The investment also funds a new IT system which enables the programme change and supports the workforce to continue to deliver a safe, high-quality programme.“The upcoming changes will be fully rolled out from 2023 and deliver on the Government’s priority to lay the foundations for a better future. However, it is really important that women who are due for screening continue to follow the existing process rather than waiting for the new test,” Dr Ayesha Verrall said. Breast cancer screeningEach year in New Zealand, approximately 3,200 people are diagnosed with breast cancer and there are around 600 deaths from breast cancer.  The national breast screening programme, BreastScreen Aotearoa (BSA), provides free mammography screening every two years to women aged 45 to 69 who have no symptoms of breast cancer.“The existing system operates as an ‘opt-in’ model, where women choose to enrol for breast screening via their GP or by calling a 0800 number. This model relies on women knowing they are eligible for free breast screening and making an appointment themselves,” Dr Ayesha Verrall said.“The current ageing IT infrastructure puts the programme at risk. It lacks the flexibility to be easily upgraded to meet the needs of the community, and is no longer supported well by vendors. That’s why, in Budget 21, we have invested up to $55.6 million in a major upgrade of the technology, and another $10 million is earmarked to match population growth and catch up on breast screens missed due to COVID-19 lockdowns.“The new technology will better equip the programme to reach the 271,000 women who are eligible to access breast screening but are not currently being screened, by being able to directly invite them and run targeted campaigns. When women are offered an appointment, they can choose to participate or ask to opt-out. “With more Māori and Pacific women dying from breast cancer compared with non-Māori and non-Pacific women, the new system will allow BSA to identify priority group women who may not already be part of the programme.“The Government is committed to improving health outcomes for our hard to reach communities and this is an important step in making that happen. “The Government already invests more than $60 million a year on providing breast screening services around the country. By boosting our investment, we will save even more lives,” Dr Ayesha Verrall said.The new system will be up and running in the next two years. Media contact: For Andrew Little – Talisa Kupenga 027 405 7231
For Dr Ayesha Verrall – Ranjani Ponnuchetty 027 575 0542
Notes to editors:What will women notice when HPV primary screening is introduced?
Women will notice two main changes:·         Routine cervical screening will only be needed once every five years, not every three years as it is currently.·         Women will have the option to self-test (expected to be more acceptable for women):o    A vaginal swab can be taken by the woman herself, or by a clinician, and then tested for HPV. The current cervical screening approach involves the use of a speculum by a clinician to take a cervical sample.o    At the start of the new programme, the process will be that a doctor, nurse or other health care worker will explain how to do the test and be responsible for getting the sample to the laboratory.o    Women with a history of abnormal cell changes, or women with a positive HPV test are recommended to have a smear test to check for the presence of cell changes. This will give clinicians more information to determine either more frequent monitoring or specialist referral for further diagnostic testing.·         The Ministry of Health will also be looking at future options to increase the accessibility of cervical screening which may include options to post self-testing kits. Why does HPV screening take two years to fully roll out?·         Significant changes are required to the programme to ensure a clinically safe transition to the new screening test including:o    Consultation on the inclusion of the option for self-testing in the clinical guidelines and referral pathwayso    The design build and test of a new population health-based ICT solution (using the National Screening Solution) required to safely support the changes to the programme, incorporating the new clinical pathways, necessary safety-nets and programme monitoringo    Education and training for providers and women on the programme change.·         Establishing monitoring and processes to support women on the current cervical screening pathway to transition to the new pathways is paramount.·         We need to support workforce capacity and capability changes to enable the programme transition, in a sustainable way that delivers high-quality, clinically safe services during and after the transition to the new primary screening test. Why do we need HPV screening if we have a vaccine?·         While the HPV vaccine protects against some high-risk types of HPV, it doesn’t protect against them all, so it’s important to have cervical screening even if you have had the HPV vaccine.·         At the same time, while the HPV vaccine is free for everyone aged 9 – 26 and certain groups, we still have some way to go to reach full population coverage. As at 31 December 2017, only 65 percent of girls born in 2003 had received their final dose of vaccine.·         Combining HPV immunisation with regular cervical screening is the most effective way to protect against cervical cancer. HPV immunisation is free for eligible New Zealand residents aged 9 to 26 inclusive.·         People under 27 years old and who have not yet been vaccinated can discuss this with their health provider

Ranjani Ponnuchetty |Press Secretary

Office of Hon Dr Ayesha Verrall

M: +64 27 575 0542 |DDI +6448178983

Email ranjani.ponnuchetty@parliament.govt.nz

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