Shane Reti: The task now is to address the backlogs as soon as possible

Address the backlog as soon as possible and re-educate people to the ongoing importance of the recommended cancer screening programs is the task now.

OPINION

The cancer agency Te Aho o Te Kahu has shown the significant impact of Covid on cancer management, especially early in the Alpha and Delta outbreaks with significant diagnostic delays for endoscopy (bowel cancer) and bronchoscopy (lung cancer). These are also some of the highest health inequities.

But what about earlier in the cancer chain, with preventative population-based cancer screening. What has been the impact of Covid on the three main screening programmes, breast cancer, cervical screening and bowel cancer?

Breast cancer screening (50,000 backlog)

The following table shows the increasing backlog in breast cancer screening, which is currently at around 50,000 people.

Breast_screening

Cervical screening (50,000 back log)

The Royal NZ College of GPs has recently reported that cervical screening has fallen behind by around 50,000 cervical smears

Bowel Screening (variable)

Nine performance measures of the bowel screening programme show variable results across each of the three DHBs that have been more than two years in the screening programme Hutt Valley, Waitematā and Wairarapa.

Some measures such as colonoscopy wait times (307) seem to have generally stood up well while others such as overall completed investigations (305) have mostly fallen out of the target range. A mixed bag.

Two of the big cancer screening programmes, breast and cervical cancer, both show significant backlogs that require urgent resources and funding.

In the context of $486m for the health reforms and $21m of routine vaccines allowed to expire, the $15m investment the Breast Cancer Foundation has identified is needed to clear the mammogram backlog should be achievable.

Covid has had a significant effect on in-hospital cancer management and not surprisingly the big population cancer screening programmes have also been impacted to varying degrees.

The task now is to address the backlogs as soon as possible and to re-educate people to the ongoing importance of the recommended cancer screening programmes.

The health system also needs to explore and innovate mechanisms for maintaining cancer screening programmes during pandemics where social distancing and cancelled outpatient clinics provide challenges.