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Hong Kong healthcare and hospitals
OpinionLetters

Letters | Hong Kong’s spending on cancer screening practices needs review

  • Requiring patients to see private doctors for consultation services before screening deprives other needed activities of funding. The Department of Health owes the public an explanation on why it is essential for participants to meet the doctors before taking the tests

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People rest and chat on a bench near the playground at Victoria Park, Causeway Bay, in July 2014. The low rate of participation in the government’s colorectal cancer screening programme, aimed at the elderly, suggests the need for more aggressive promotion. Photo: James Wendlinger
Letters
Referring to the two letters by Chinese University researchers in June and September, we agree that the government should promote colorectal cancer screening through a range of activities and targeting ethnic minority groups. As such activities require additional financial support, the government must review its current practices of hiring private doctors to offer consultation services before the screening.

According to the Department of Health, since the launch of the programme in 2018, about 195,000 people aged 50 to 75 had had their stool samples tested as of September 2020. With the total population of this age group at around 2.6 million people, the programme’s participation rate is only 7.5 per cent, suggesting the need for more aggressive promotion.

One significant cost item of this programme is the consultation cost of HK$280 paid to the private doctors who meet each participant before the tests. If the entire eligible population joins the programme, the consultation meetings would cost more than HK$730 million (US$94 million).

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In response to our inquiry, the Department of Health said that meeting the doctors was essential as patients with high risks of colon cancer could not take the tests and should be identified through consultation. Yet, it is not clear what harm would be caused if these patients had their stool samples tested.

The department also said doctors should explain to the participants the purpose of the screening, obtain their consent and educate them on how to collect specimens and enter participant data into the information system. We believe these tasks can be performed by nurses or social workers at a much lower cost.

Similar programmes have been implemented in countries such as Canada, the Netherlands and the UK. Participants there submit their stool samples and relevant paperwork by mail.

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