Screening strategies adopted by Hong Kong for three of the commonest cancers that strike women are inefficient and poor value for money, University of Hong Kong medical researchers say. A more organised approach could save more lives and reduce the amount of productive time lost because of breast, cervical and colorectal cancers without spending any more money, the doctors say in a just-published research paper. In their research, community medicine professor Gabriel Leung and post-doctoral research fellow Pauline Wong Pao-sun set out to develop a cost-effectiveness model of screening for the cancers among Hong Kong-Chinese women. They found pap smears every five years for all women from the age of 25 and a colonoscopy every 10 years for women aged 50 and above would improve the survival rate by 21/2 times. But they question the value of mammograms to screen for breast cancer, saying the city would have to double the HK$400 million it spends on cancer screening and treatment before these could be considered 'a good buy' for older women. Altogether, the three cancers were responsible for 13,556 disability adjusted life years (Dalys) - years of life lost due to premature mortality plus years lived with disability - in the city's 3.4 million women annually, the study found. The researchers contended that current 'opportunistic' screening strategies in Hong Kong - where individuals are left to decide when and how often to have screening - were an 'inefficient deployment of scarce health dollars' as they averted only 471 Dalys a year. Using a table developed in the study, Professor Leung said spending the present HK$400 million a year, Hong Kong 'would be able to buy Pap screening essentially for every woman every four years and colorectal screening every 10 years for about a third of the female population' and potentially step up the benefits to 1,161 Dalys. But a cancer specialist, Kevin Loh Kai-tsu, president and CEO of AmMed International Corporation, argued that a mammogram has to be done every year to be effective.
