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To combat Hong Kong's most common cancer, colorectal cancer, the Department of Health (DH) will tentatively launch in September this year a Screening Pilot Programme under which eligible Hong Kong residents aged from 61 to 70 will be invited in batches to undergo screening tests over a three-year pilot period.
At a press briefing to report on the progress of preparation for the Screening Pilot Programme held today (April 14), the Controller of the Centre for Health Protection of the DH, Dr Leung Ting-hung, said colorectal cancer ranked highest among the 10 most common cancers in Hong Kong in 2013, and was the second most common cause of cancer death in 2014 after lung cancer.
"The median age of colorectal cancer diagnosis is 68 for males and 71 for females, and occurrence of colorectal cancer among individuals aged 50 or above is common. In view of the growth of an ageing population, an increasing burden of colorectal cancer on individuals, families, healthcare services and society is anticipated," Dr Leung said.
"Of note, risk factors of colorectal cancer include obesity, lack of physical activity, frequent consumption of red and processed meat and low intake of fibres such as fruit and vegetables, alcohol use and smoking. Colorectal cancer is preventable through a healthy lifestyle and well-organised screening," he said.
"Colorectal cancer is a major threat to health and it may not be easily recognised in its early stages. Polyps that turn into cancer often shed tiny amounts of blood not visible to the naked eye but can be picked up by a sensitive stool test," he added.
The Government announced in the 2014 Policy Address that it would subsidise colorectal cancer screening for specific age groups. The aim of the screening is to identify people who have colorectal cancer before they have symptoms, or those who are more likely to develop cancer, so that treatment can start earlier and disease outcomes be improved.
The target group of the screening programme is eligible Hong Kong residents born in 1946 to 1955, i.e. aged from 61 to 70 in the year 2016. To assist the smooth operation of the programme they will be invited to receive screening in batches, with those born from 1946 to 1948 as the first cohort for participation, tentatively beginning this September. Arrangements for those born between 1949 and 1955 will be announced in due course. It is expected that some 300,000 attendees will undergo screening during the three-year pilot period.
Also speaking at the press briefing, the Head of the Surveillance and Epidemiology Branch of the Centre for Health Protection, Dr Regina Ching, outlined the preparatory work progress of the screening programme and appealed to doctors and eligible people to join the programme.
"By applying sensitive screening tests, we can pick up individuals with small amounts of blood in their stool so that colorectal cancer in its early stages can be treated more promptly and effectively with improved outcomes," Dr Ching said.
She noted that the screening programme would adopt the Faecal Immunochemical Test (FIT), a new version of faecal occult blood test, as the screening tool. FIT is a safe and effective screening test as indicated by local and overseas experience. It is simple to implement for a large number of participants and evidence has shown that it can reduce colorectal cancer mortality by 15 to 33 per cent.
The screening pathway will comprise two stages. Eligible persons will first visit a Primary Care Doctor (PCD) participating in the Pilot Programme, and enroll into the screening programme. They then receive a government subsidy to undergo FIT as the first line screening test. If the FIT result is positive, the PCD will then advise the participant to undergo colonoscopy assessment to find out the cause of bleeding. Polyps found will be removed to confirm or exclude the presence of cancer. The participant may visit any Colonoscopy Specialist (CS) of choice who has enrolled in the Pilot Programme.
The whole process will be heavily subsidised by the Government to encourage the public to participate and go through the screening pathway. The Government will provide the subsidy for the FIT screening offered by the enrolled PCD and the specified scope of colonoscopy services provided by the enrolled CS for individuals with a positive FIT result.
Dr Ching said, "The subsidy amount for each consultation at the enrolled PCD's clinic is $280, which should generally be sufficient so that the participant may not need to make an additional payment.
"As for colonoscopy assessment, the Government subsidy would be $7,800 or $8,500 for the defined scope of services depending on whether colonic polyp(s) are found and removed. We understand that some enrolled CSs, on top of the government subsidy, may charge more for various reasons. There will be a cap of $1,000 for this copayment amount in order not to deter participants with a positive FIT result from receiving colonoscopy services."
The DH will upload detailed information including the scope of the services provided by enrolled PCDs or CSs onto its dedicated Prevent Colorectal Cancer website at www.colonscreen.gov.hk to facilitate public understanding and enhance programme transparency.
Enrolment of PCDs and CSs as service providers in the Pilot Programme will begin tomorrow (April 15). The DH is also sending invitation letters to doctors and organising briefing sessions for key stakeholders and partners. Doctors who are interested in enrolling in the Pilot Programme may visit the dedicated website for more information.
A dedicated IT system linked to the territory-wide electronic Health Record Sharing System (eHRSS) launched in March this year is being developed, with important functions such as keeping participants' screening results and history, and which can follow participants through the screening pathway. The DH is appealing to prospective service providers and eligible people who intend to join the screening programme, to complete eHRSS enrolment procedures well ahead of the launch of the Pilot Programme. Details of eHRSS registration are available at www.ehealth.gov.hk.
Joining the press briefing with the DH officials, taskforce member of the Pilot Programme Professor Martin Wong shared his experience in prescribing the screening test in primary care settings and related research findings. Professor Wong pointed out that FIT is widely accepted by users as it requires no diet or medication restrictions before testing and allows samples to be collected at home.
Also attending the press briefing was another taskforce member, Dr Judy Ho, who briefed the media on the screening pathway for a participant with a positive FIT result and shared her experience of performing colonoscopies.
To allow early implementation of the Colorectal Cancer Screening Pilot Programme, the DH embarked on the relevant study and planning work in January 2014. A multi-disciplinary taskforce and four working groups, comprising representatives from various medical associations and professional bodies, academic institutions and non-governmental organisations, were established. In this context the three-year Pilot Programme will be launched by the DH with the aim of gathering relevant local experience to draw conclusions and make recommendations as to whether and how best colorectal cancer screening services may be provided to the wider population in future.
More details of the launch date and implementation of the Pilot Programme will be announced later this year.
Ends/Thursday, April 14, 2016
Issued at HKT 18:07
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