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Monday, 15 February 1999
Page: 2663

Ms PLIBERSEK (12:41 PM) —I rise to support the motion by the member for Hume on breast cancer. Breast cancer is a major issue of concern for Australian women. Certainly, more Australian women die from breast cancer than from any other form of cancer. About 2,700 Australian women die each year from breast cancer and one in 11 women are diagnosed with breast cancer during their lifetime. The research response in Australia needs to be well funded, co-ordinated and relevant to the Australian context.

To date our major response to breast cancer has been a national population-based screening program. In June 1990, the ministers responsible for health in all states and territories joined the Commonwealth in agreeing to jointly fund a national mammography screening program. In March 1990, Prime Minister Hawke announced that the Commonwealth government would implement the National Program for the Early Detection of Breast Cancer and committed $64 million in the 1991-92 budget for that program. In the 1994-95 budget, the Commonwealth committed a further $236.6 million over five years from 1994-95 to 1998-99 to continue the program.

The National Program for the Early Detection of Breast Cancer, now known as Breastscreen Australia, was established in 1991 and is now recognised as one of the most comprehensive population-based screening programs in the world. The program provides free screening mammograms at two-yearly intervals mainly to women between the ages of 50 and 69 years. Breastscreen Australia operates in over 500 locations nationwide, via fixed, relocatable and mobile screening units. Screening has increased significantly since commencement of Breastscreen Australia in 1991, with over 52,000 women now being screened each month. The program's aim is to reach a participation rate of 70 per cent among their target group. At present, unfortunately only 54 per cent of women in the target group are being screened.

Mammographic screening is the most effective method of prevention currently available, but it is certainly not fully effective. Early detection while the cancer is still localised in the breast means that women have a 90 per cent chance of survival after five years, whereas if the cancer has spread, the survival rate after five years is only 18 per cent. So the importance of early detection is plain from those figures. However, screening only has a reduction of about 30 to 35 per cent in the death rate from cancer which means that unfortunately the majority of women who are screened still die from breast cancer. That shows us the importance of continuing research in other areas of treatment, certainly in the causes of breast cancer.

The member for Hume has detailed a number of the funding sources for breast cancer. Certainly, the National Health and Medical Research Centre provides a number of breast cancer projects. They also give block grants to the Garvan Institute of Medical Research, to the Walter and Elizabeth Hall Institutes and to a number of other projects which are looking at breast cancer.

They have also set up the National Breast Cancer Centre, which was provided with $16.4 million over four years to coordinate research findings and to disseminate accessible information to patients and doctors on best practice, treatment and management.

In 1996 the National Health and Medical Research Council tallied up breast cancer research for that year, and it was sadly only $12.24 million at that time, which I do not think compares favourably with the amount of money we have spent on things such as the advertising campaign for the tax package in the lead-up to the last federal election.

But more money for breast cancer research is only part of the challenge. The other challenge is coordinating that research to make sure it is effective. The important challenge is to make sure that every dollar of breast cancer research is well spent as well as increasing the actual amount that is spent. The National Breast Cancer Centre has suggested that a National Action Plan for Breast Cancer Research be developed to ensure that level of coordination. The centre said:

This would provide both government and community with confidence that their funds are being used well. A National Action Plan for Breast Cancer Research which brought together key players and developed a coordinated approach would ensure that funds available for breast cancer research are used optimally through a rigorous peer review system, reassure the community that potential duplication of effort was being avoided, and offer the opportunity for fostering research in areas where additional effort is needed.

They suggest that that plan could have input from the National Health and Medical Research Council, the Kathleen Cunningham Foundation, the National Breast Cancer Centre and the various other research institutes and government departments which have a role in undertaking research in this area.

They suggest that the plan should emphasise the importance of a competitive peer review process for allocating the funding that is available, and continue support for existing research activity, because that activity is already in line with a number of priorities which have been identified as areas for further research, such as biological causes, genetic factors, development of new treatments, risk factors, evaluation of new treatments and diagnosis.

The plan should also undertake further research in areas that are perceived as important by the consumers of breast cancer research but where little research is currently undertaken—that is, psychosocial and supportive care, and alternative therapies. The breast care centre suggets that, with the knowledge that government funding will continue, it is very important not to have any duplication of research. One of the roles that they suggest that either the National Health and Medical Research Council's National Breast Cancer Centre or the Kathleen Cunningham Foundation can play is in providing something like a clearing house for breast cancer research that is currently being undertaken. This would prevent duplication but also allow collaboration between researchers so that money can perhaps be used more effectively by piggybacking on existing research in other areas.

The other particular point that I wanted to make today is that Australia has a relatively small and diffuse population, so one of the challenges for us in an Australian context is to make sure that we take up challenges that may not be covered by research from other countries. One of the most pressing issues is investigation into the experiences of Aboriginal and Torres Strait Islander women with breast cancer. We also have to have a very serious look at the experiences of women living in rural and regional areas—their access to screening and treatment, to peer support networks and to supportive doctors and other clinicians.

The other area I briefly wanted to mention is the success of the use of public figures talking about their experiences with breast cancer. Many people in the Australian community would have read of the experiences of Belinda Emett, the young actor who was only 24 years old when she was diagnosed with breast cancer. The experiences of someone in that position who is willing to share those experiences certainly provide a role model for young women so that they continue to do regular breast self-examination and seek prompt treatment and attention as soon as they have any problems. It is an interesting fact that over half of the breast cancers that are diagnosed in New South Wales are bigger than two centimetres. (Time expired)