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Thursday, 30 June 1994
Page: 2476


Senator SANDY MACDONALD (4.02 p.m.) —I rise today to support the tabling of the report of the Senate Standing Committee on Community Affairs inquiry into breast cancer screening and treatment in Australia. It is with a great sense of expectation and hope that the committee delivered its report to the Senate for consideration. There are very few diseases in the annals of medicine that reap such an horrific human harvest as breast cancer. It is a profound national and international problem. It terrifies each and every woman, and it should be a concern of each and every man.

  During the 1990s so far there have been more than 70,000 Australian women diagnosed with this disease, 25,000 deaths and statistically over half a million years of life lost. To quote a recent article in an Australian women's magazine, if news bulletins announced breast cancer deaths the way they report the road toll there would be a national outcry. In monetary terms the total cost to Australia during this decade is estimated to be over $2 billion.

  Breast cancer is not a new disease; it has been well documented for over 5,000 years, but this year it will continue to kill 2,500 Australian women. This equates to six women a day or one woman every four hours. Breast cancer affects one in 15 Australian women at some stage in their lives, and trends from the United States suggest that it may be as high as one woman in 12 as the decade wears on.

  Potential lifestyle factors determining this increase require further research, and this is starting to be done. Between 1977 and 1989, the incidence of breast cancer in New South Wales rose 21 per cent. Sadly, neither the cause of breast cancer nor the means of preventing it are known. The major initiatives required to address this epidemic are screening for early detection and easier access to high quality treatment. Educating women is also of vital importance.

  To be effective in reducing mortality, the national program for the early detection of breast cancer needs to achieve a high participation rate in the high-risk age groups—that is determined to be the 50- to 69-year-old women. A report of the screening evaluation coordination unit estimated that if 70 per cent of women aged between 40 and 69 years participated in the program there would be a 16 per cent reduction in mortality amongst Australian sufferers. Based on overseas studies, individual women participating regularly in quality mammographic screening can anticipate a 60 per cent reduction in the risk of death from breast cancer. The factors reducing death rates include not only regular mammography screening but also the provision of quality diagnostic screening and assessment services by multidisciplinary specialist teams.

  Breast cancer is likely to have an impact on every one of us during our lifetimes. We all have mothers, sisters, aunts, nieces and colleagues. In my local city of Tamworth, a successful businesswoman I know, Bev Barnsley, has had two encounters with this terrifying disease in the space of 14 years. Bev was a 43-year-old mother in 1980 when she was found to have a small cancerous lump in her breast. It was surgically removed. Then in 1987 the unthinkable happened and a second cancer was discovered through Bev's annual mammography screening. This time she underwent a mastectomy. Bev said, `I believe because I had a mammogram I am alive today.' She continued, `I really don't give much thought to my cancer now in reference to myself. I don't drop my guard but I look forward.' She looks forward with hope and help from regular screening.

  I am sure my colleagues will join with me in wishing a quick recovery to former shadow health minister Senator Jocelyn Newman, somebody we all hold dear. Senator Newman lobbied hard in this place for increased breast cancer funding and should be applauded for her tireless efforts.

  In this year's budget the government, to its credit, provided extra funds for the continuation and expansion of the national screening program. An amount of $93 million was provided for health and medical research—not specifically for breast cancer—and the government tells us that increased funding for breast cancer research projects is expected to result. I think this means that, if breast cancer research applications are not considered to be good enough, there will be no funding. The proposed annual $2 million funding for a national breast cancer centre may have been better spent on tax deductibility for private donations to existing research foundations. I commend the government for its additional funds, however; I think it is going in the right direction.

  I commend the New South Wales government's decision to spend $4.5 million to fast-track breast cancer screening programs. I call on the federal government to match this commitment so that by June 1996 screening services can be available across the whole of New South Wales to women in the high-risk age range of 50 to 69. Some of the services will be new centres for screening while others will be mobile or relocatable units. As well, the New South Wales government will fund four new minibuses to move around the state helping women in isolated areas to have access to these services. This is important as rural women often miss out on services because of their geographic isolation.

  Already New South Wales has provided free screening to more women than any other state. In 1988 there was no population based screening service in New South Wales: now, thanks to the joint federal and state government funding, we have seven screening and assessment services providing screening services through 29 fixed and mobile screening facilities. That brings me to the north and north-west breast screening service which operates in the Tamworth and the north-west region. This service began a screening and assessment service in the New England and north-west slopes area in March 1991. In true country style the service was initiated by community action stimulated by the Rotary Club of Glen Innes.

  The New South Wales government agreed to the provision of recurrent funding to support the operation of a dedicated mobile breast screening unit. The total cost of the unit was then $300,000. Fundraising in areas around Tamworth assisted in developing a breast disease diagnostic clinic and health service at Tamworth Base Hospital.

  The service was evaluated as a pilot program for rural New South Wales in conjunction with the New England public health unit. The community again supported the service by raising funds for the expansion of the screening unit and assessment centre in Tamworth. Most of the funds for this expansion have come by way of the NBN telethon, and many individuals, community groups and business organisations throughout the region have made specific contributions.

  As at May of this year the service had provided over 12,000 initial screening mammograms to women in 20 local government areas in the screening area. Of these, nearly 6,500, or 52 per cent, are in the target age group of 50- to 69-year-olds. Fifty-three cancers have been detected at initial screenings at a rate of 4.3 per 1,000 women. This rate is a little below the national average but that is only because of the higher number of women below 50 who have been given access to the screening facility. A further nine cancers have so far been detected at the second round of screening. Six interval cancers are known to have been detected symptomatically within 12 months of screening. This indicates that screening is not a catch-all but it is a great help. This is a groundbreaking service that serves as an example for all rural and regional areas in Australia.

  In conclusion, I urge the Senate to seriously consider each of our recommendations. The report contains many important recommendations, including that strategies be implemented to improve access to the program in rural and remote areas. This could involve financial assistance to help women access the program. Additionally, the focus of the program remains on women aged between 50 and 69, but the committee made clear that mammographic screening should continue to be available to women aged 40 to 49 and of course to those over 70 years of age. (Time expired)