Editorial: Breast screen extension needed now

A stylish range of T-shirts went on sale in Glassons fashion chain this week. That fact would normally do no more than gain the passing interest of fashionable types. These T-shirts, however, have a special purpose: they are to raise funds for research into a disease that kills more than 600 New Zealand women a year. The disease is breast cancer.

Days before the T-shirts went on sale the Breast Cancer Research Trust announced increased funding for the University of Auckland, money that will not only allow more research but possibly the appointment of a dedicated professor of breast oncology. That is good news in an area of medicine in which the incidence of the disease is expected to rise through an ageing population, delayed child-bearing and women having fewer babies - all factors that increase the breast cancer risk.

Research into causes and treatments is vital but so, too, are the screening programmes that lead to early detection. It is well understood that the chances of beating the disease are increased markedly by discovering abnormalities in the early stages of development. An Auckland breast cancer register showed last year that, compared with past studies, tumours are being detected when they are smaller. Researchers put this down to greater awareness of breast cancer, and breast screening. About 2000 New Zealand women are diagnosed with the disease each year and 30 per cent die. The mortality rate is falling but it is still about 28 per cent higher than in Australia. Could that be because breast screening across the Tasman is available to women aged between 40 and 70 while in New Zealand the programme is limited to women aged 50 to 64?

The arbitrary age selection in the New Zealand programme must be based solely on financial considerations. Certainly it is not based on the notion that women under 50 do not get breast cancer. They do, and the likelihood is that the condition will be more serious in younger women. Research based on the Auckland register revealed more aggressive breast cancer in women under 40 with twice the incidence of faster-growing, grade three tumours than in women over 40. At the other end of the scale, research indicates that if women were screened up to the age of 70 there would be a significant decline in the cancer mortality rate in that group.

There is debate over the screening of women aged 40 to 50 because of the incidence of false positive results. That is not, however, a reason for denying free screening to women in that group who have a family history of the disease and who are, therefore, at greater risk.

In November a petition signed by 124,000 people was presented to Parliament urging that the screening programme be brought into line with Australia's. The petition should have served as a wake-up call for Health Minister Annette King, who said through a spokesman last July that there would be a statement on broadening the age range for free mammograms "later in the year". The spokesman made it clear that Mrs King was considering broadening the age range. So far there has been no statement and no commitment to match the Australian programme. And Canberra is not alone in recognising the need to screen a broad age range. Britain, too, has lately extended its service to 70-year-olds.

There is compelling evidence of the worth of such programmes. Not only do they save lives but they must surely be more cost-effective than treating an invasive condition with radical surgery, chemotherapy and radiotherapy when the disease has progressed.

Punk-pop star Kelly Osbourne, who designed one of the T-shirts, said she wanted to be involved in the campaign because "if I can help even one person through this it would make all the difference to me". The Minister of Health has the capacity to help many more women than that.