Following is a question by the Hon Nixie Lam and a written reply by the Secretary for Health, Professor Lo Chung-mau, in the Legislative Council today (January 22):
Question:
There are views that women should undergo annual gynaecological examinations (including cervical smear test, breast examination and pelvic examination) from puberty onwards and, as they get older, examinations such as bone densitometry, mammography and endometrial sampling checks should also be undergone. Moreover, it is learnt that many women lack basic knowledge about gynaecological health and regular screening, and do not know how to access information about the relevant examinations. In this connection, will the Government inform this Council:
(1) as it is learnt that the Department of Health has set up a web page to provide relevant information on women's health, whether the Government has plans to update the web page to provide a one-stop summary of the health examinations required and the relevant medical knowledge for women from puberty, reproductive age to menopause; if so, of the specific details; if not, whether it has plans to set up a one-stop website for women's reference to ensure that they can obtain appropriate information on health examinations;
(2) as there are views pointing out that the main reasons for women not undergoing regular gynaecological examinations are the high costs, and a lack of initiative and information about the channels for such examinations, of the names and contents of all the public gynaecological screening programmes currently provided by the Government; how the Government will enhance the dissemination of information regarding these programmes to facilitate women's access to such information; and
(3) how the Government plans to: strengthen the promotion of sex education for puberty in schools to assist young women in understanding bodily changes and health management; make reproductive health knowledge popular among women of reproductive age to help them formulate birth plans expeditiously; and provide women undergoing menopause with health knowledge and psychological support to assist them in getting through this stage of life smoothly?
Reply:
President,
The Government attaches great importance to women's health, and is committed to providing quality medical and health services to women of different ages. The Woman Health Centres (WHCs) and Maternal and Child Health Centres (MCHCs) of the Department of Health (DH) provide subsidised woman health services for women aged 64 or below. The scope of service includes health education, assessment, counselling, as well as investigations as appropriate (including breast cancer and cervical screening services). The Hospital Authority (HA) provides comprehensive and quality healthcare services in the public healthcare system, including gynaecology services. In addition, the Primary Healthcare Commission (PHC Commission) has published the Hong Kong Reference Framework for Life Course Preventive Care in Primary Healthcare in September 2023 to provide a set of evidence-based comprehensive health guidance. A reference framework on life course preventive care plan for women's health across various stages of life (from puberty through reproductive years to menopause) will be published by the PHC Commission in the first quarter of 2025 to enhance women's self-health management capabilities.
In consultation with the Home and Youth Affairs Bureau (HYAB), the Education Bureau, the HA, the DH and the PHC Commission, the consolidated reply to the question raised by the Hon Nixie Lam is as follows:
(1) The DH has been collaborating with relevant government departments to disseminate information on women's health to the public through various channels. Apart from the dedicated website on women health (www.fhs.gov.hk/english/health_info/class_topic/ct_woman_health/ct_woman_health.html) set up by the DH, the HYAB also launched a one-stop Family and Women Portal (the Portal)(www.familyandwomen.gov.hk/) in October 2024, which pools together information related to family and women, including practical information on women's health. The Portal provides information on the WHCs and the MCHCs of the DH, the Chronic Disease Co-Care Pilot Scheme (CDCC Pilot Scheme), etc. for easy access by the public. The Portal also collates information offered by the DH on common diseases and check-ups for women, as well as information on women's health at different stages of life, such as healthy diet for adult women, preparation for pregnancy, healthy diet during pregnancy and breastfeeding, antenatal and postnatal mental well-being, physiological and psychological changes during menopause and bone health to help women and members of the public prepare for different stages of life. The Portal also regularly uploads feature articles and videos, and invites relevant professionals or experts to introduce specific topics in individual areas, such as women's emotional health and understanding the menopause well-being of women from the perspective of Chinese medicine. The Government will continue to review and enrich the content of the Portal.
(2) According to the statistics of the Hong Kong Cancer Registry of the HA, among the new cancer cases (35 373) in Hong Kong in 2022, the number of female's cases (18 134) was higher than that of the male's (17 239). Breast cancer and corpus uteri cancer were the second and seventh most common cancers in Hong Kong in 2022 respectively. Cancer prevention and control is an important part of women's health. The Government has been promoting evidence-based cancer screening according to the Hong Kong Cancer Strategy. The objective is to detect cancers or to identify precancerous disease early so that treatment can be carried out more effectively. The Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) has so far formulated relevant recommendations on screening of 11 cancers in Hong Kong, including cervical, breast, ovarian cancers.
Based on the recommendations of the CEWG, the Government has launched a city-wide Cervical Screening Program since 2004. Eligible women may receive subsidised cervical screening services at the MCHCs and the WHCs. According to the DH's Population Health Survey 2020-2022, about half (52.1 per cent) of women aged 25 to 64 in Hong Kong had undergone cervical screening. The coverage rate is comparable to that of some neighboring regions such as Japan.
In addition, the Government has implemented the Breast Cancer Screening Pilot Programme (BCSPP) by adopting a risk-based approach. Starting from the second half of 2021, the BCSPP has been rolled out in the WHCs, four MCHCs and 18 Elderly Health Centres (EHCs) under the DH to provide breast cancer screening services for eligible women aged 44 to 69. Women identified to be at increased risk of breast cancer by the breast cancer risk assessment tool will be referred by the DH to the outsourced imaging centre for mammography (MMG) screening and supplementary breast ultrasound scanning. As at October 31, 2024, 35 439 women received breast cancer risk assessment under the BCSPP, amongst which 10 113 (about 28.5 per cent) received MMG screening (including breast ultrasound screening where necessary) according to the risk assessment, which is comparable to the findings of the study conducted by local university.
Besides, the District Health Centres (DHCs) / District Health Centre Expresses under the PHC Commission in all districts across the city are actively assisting members of the public (including women, children and students) in formulating individualised life course preventive care plan based on factors such as one's gender, age and family history. Life course preventive care plan is an evidence-based comprehensive health strategy that emphasises on prevention and personalised needs and provides guidance on the health needs of citizens across different stages of life. Individual DHCs may even provide members of the public with relevant women health education and information (e.g. prevention of osteoporosis, cervical or breast cancer) according to their needs. The DHCs have also been actively complementing the government cancer screening programmes, including identifying risk factors associated with cancers through conducting health assessments for DHC members to provide support to members of the public to continuously manage such risk factors. Meanwhile, the DHCs assist and refer eligible persons to doctors who have been enlisted in the Primary Care Directory and enrolled in the government cancer screening programmes for screening.
The above relevant information on woman health services is available for further access on the websites of the DH and the DHCs and/or the HYAB's Portal.
(3) It is set out in "The Chief Executive's 2024 Policy Address" that, having regard to the demographic profile of Hong Kong and the health needs of different social groups, the DH will devise health promotion strategies by adopting a life-course framework to formulate health management plans for members of the public according to their age and health conditions. The strategies will cover all age groups, from birth, schooling, adulthood and employment, as well as different stages of life of women from pregnancy to old age. Meanwhile, the Government has been providing various health services to protect the health of women of different age groups.
For infants and young children, the MCHCs of the DH provide free vaccination services to eligible infants and young children from birth to five years of age under the Hong Kong Childhood Immunisation Programme (HKCIP) for the prevention of 11 types of infectious diseases, including tuberculosis, hepatitis B, poliomyelitis, tetanus, pertussis, measles, diphtheria, mumps, rubella, chicken pox and pneumococcal disease. Over 90 per cent of locally born babies visit MCHCs for services including immunisation every year. Since the 2019/20 school year, human papillomavirus (HPV) vaccination has been arranged for Primary Five and Primary Six schoolgirls under the HKCIP. The School Immunisation Teams of the DH provide the first dose of HPV vaccine to eligible Primary Five female students at their schools and the second dose will be given to them when they reach Primary Six in the following school year. In response to the earlier recommendation of the Scientific Committee on Vaccine Preventable Diseases to expand the target group of HPV vaccinations to older girls aged 18 or below, the Government launched a one-off free catch-up vaccination programme by phases for eligible female Hong Kong residents who were born in 2004 or after, and have not received HPV vaccination.
To cultivate healthy lifestyle among students from an early age as they attend the school, the DH has launched the Whole School Health Programme (WSHP), making reference to the Health Promoting School framework advocated by the World Health Organization. The DH assists schools in systematically reviewing and formulating measures to promote physical activity, healthy eating, mental health and social well-being through guidelines and checklist, and gradually becoming a healthy setting for living, learning and working. The DH provides health promotion activities for students such as outreach health talks in schools, covering healthy lifestyle, mental health and social well-being. Topics include those related to sex education, such as changes during puberty, techniques for interacting with the opposite sex, relationship between sex and love, importance of safe sex, principles and methods of contraception, sexual harassment and its management. It is announced in "The Chief Executive's 2024 Policy Address" that the WSHP will be strengthened, and that health reports will be compiled for each participating school to recommend targeted school-based health promotion measures.
In the secondary and primary school curriculum, equipping students with the knowledge about the physiological, personal hygiene habits, psychological and social changes during puberty is part of the learning content of sex education. Schools help students understand the changes in their bodies, acquire the knowledge of managing their health and nurture in them proper values for developing a positive and healthy attitude to embrace the changes in growth through related subjects including General Studies/ Primary Humanities, Primary Science, Citizenship, Economics and Society in junior secondary, Ethics and Religious Studies, Biology and Health Management and Social Care in senior secondary, in conjunction with school assemblies, class teacher periods, school-based civic education and personal growth education lessons, life-wide-learning activities and seminars.
For women of reproductive age, the MCHCs and the WHCs of the DH provide them with health services and information, including antenatal, postnatal, parenting education and family planning services, with a view to preventing disease and promoting health. The DH also subsidises the Family Planning Association of Hong Kong to provide preventive, early detection and treatment services to promote sexual and reproductive health.
As for menopause and elderly women, the DH provides women with health information on menopause through the services provided by the MCHCs and WHCs, as well as websites and printed materials. The 18 Visiting Health Teams of the DH reach out to the community to provide health promotion activities to the elderly and carers in collaboration with other elderly service providers so as to promote healthy ageing, improve the elderly's self-care abilities, as well as to reduce the risk of diseases. A wide range of training topics are covered in the related activities, including various priority areas such as healthy eating, physical activity, reduce alcohol-related harm, mental health promotion, injury prevention and sexual health. The DH has also set up a dedicated website for elderly health service to promote healthy living and improve the self-care ability of the elderly so as to minimise the risk of illness and disability among elderly. To take forward the development of primary healthcare, it is announced in "The Chief Executive's 2024 Policy Address" that the Government will upgrade more District Health Centre Expresses into the DHCs, and expand the service network while integrating the services of the WHCs and EHCs.
In addition, the DHCs under the PHC Commission will provide health risks assessment, women health-related promotion and education to women in need, and encourage women to develop self-health management and healthy lifestyles at different stages of their lives. As at December 31, 2024 (provisional figures), the accumulated number of DHC members was 349 948 (115 611 male members and 234 337 female members), and the number of participants of the CDCC Pilot Scheme (which currently covers screening services for diabetes mellitus and hypertension, and will be expanded to also cover blood lipid tests within this year in accordance with "The Chief Executive's 2024 Policy Address") was 92 999 (30 661 male participants and 62 338 female participants). The male-to-female ratio of the number of participants were both around 1:2.
In future, the Government will continue to provide quality medical and health services to women of different age groups.
Follow this news feed: East Asia