Hong Kong health care and hospitals

HKU assigned to launch study on breast cancer risk and pave way for local universal screening

Local expert says breast cancer risk is highest at the age of 45, and it is advisable for women to start considering baseline screening at 40

PUBLISHED : Saturday, 10 March, 2018, 3:09pm
UPDATED : Saturday, 10 March, 2018, 11:29pm

The Hong Kong government has commissioned the first local study on breast cancer risks to determine if women in the city should receive universal screening, the Post has learned.

The University of Hong Kong will helm the project, with a report expected in March next year.

Led by Professor Gabriel Leung from HKU’s school of public health, the study will develop a risk prediction model specifically for Hong Kong and identify risk factors for a disease that claimed the lives of 702 local women in 2016.

Could universal breast cancer screening be coming to Hong Kong? Leader Carrie Lam hints at policy change

A spokesman for the Food and Health Bureau confirmed the study, adding it would collaborate with 15 public hospitals, six private hospitals, and six private practitioners to collect data and samples.

On Thursday, Chief Executive Carrie Lam Cheng Yuet-ngor revealed that officials will explore whether a population-wide mammography programme is needed for asymptomatic women or those at average risk.

Breast cancer is the most common form of cancer among women and the third leading cause of cancer-related mortality in Hong Kong. There were 3,920 new cases in 2015, accounting for about 26 per cent of all new cancer cases among local women.

“The incidence is rising in Hong Kong,” the bureau spokesman said. “But there remains important gaps in the evidence to support optimal mammographic screening strategies as secondary prevention methods for non-Western women.”

He added there was a need to identify relevant local risk factors for breast cancer and develop a model based on this for screening.

Experts from around the globe are divided on the benefits of more screenings and the ideal age for this. Some researchers suggest that these tests can lead to a wrong diagnosis, putting patients under unnecessary anxiety and financial pressure, especially when they have to undergo additional procedures such as a biopsy.

Women treated for some breast cancers remain at risk for 20 years, according to latest study

But a local expert pointed out that screenings were shown to reduce breast cancer mortality rates by 23 to 31 per cent in many countries.

Dr Sharon Chan Wing-wai, clinical director of Kowloon East Cluster Breast Centre in United Christian Hospital, cited a recent Taiwanese study that found mortality rates could be reduced by 41 per cent through universal biennial mammography screenings.

Early detection of small tumours would lead to more chances for treatment and an increased survival rate, Chan said.

“Although the study has its limitations, it did show the benefits of breast screening in an Asian locality,” Chan said.

She said the risk of breast cancer is highest at the age of 45, and it was advisable for local women to start considering baseline screening at 40.

In the US, the American Cancer Society states in its guidelines that women aged 45 to 54 should undergo a mammogram every year, and those 55 and older should go for check-ups every two years.

“This was not implemented in Hong Kong as [it was] the government’s opinion that the situation in the city or in Asia is different, and we do not have local data to support population screening,” Chan said.

“However, the government is now conducting a study involving multiple centres to look into local data. I hope the study will help provide more evidence to support policies for breast screening in Hong Kong.”

The Breast Cancer Foundation has been pushing for a population-wide programme, but only private organisations and NGOs offer breast cancer screening in the city, which can cost a few thousand dollars.

A total of 21,082 women received mammograms at public hospitals in 2015.