The Secretary for Health, Professor Lo Chung-mau, chaired the 19th meeting of the Cancer Coordinating Committee (CCC) today (June 28) to review the implementation of the Hong Kong Cancer Strategy and discuss the response strategies and measures with relevant government departments and organisations.
Professor Lo said, “Cancer has been the top killer in Hong Kong for years, claiming over 40 lives every day on average. Promulgated in July 2019, the Cancer Strategy was the city's very first holistic plan formulated for cancer prevention and control, setting out a series of strategies regarding cancer prevention and treatment for the period between 2020 and 2025. In collaboration with healthcare professions and different sectors of the community, various evidence-based actions in response to cancer have been implemented in a co-ordinated manner.”
At the meeting, the CCC reviewed the city-wide population-based cancer data for 2021, as well as various cancer surveillance indicators such as incidence, mortality and survival rates of major cancers. In particular, a total of 38 462 newly diagnosed cancer cases were recorded in Hong Kong in 2021, involving 18 943 males and 19 519 females. In other words, 105 people were diagnosed with cancer every day on average. Lung cancer and breast cancer were the most commonly diagnosed cancers among men and women respectively.
Professor Lo said, “The overall survival rate for cancer patients in Hong Kong has increased steadily over the past two decades. As shown by the stage-specific survival rates of multiple cancers, the survival rate will be much higher if a patient has the cancer detected at an early stage followed by early treatment. Most patients with early-stage cancers have a five-year relative survival rate reaching 90 per cent or higher. Among them, the ratio of surviving for more than five years for those with certain early-stage cancers (such as breast, prostate and thyroid cancers) is comparable to that of the general population. The well-established local cancer database not only provides reliable data for important referencing for cancer surveillance, but also serves as an important resource for the Government and various stakeholders to formulate cancer prevention and control strategies as well as drive healthcare development.”
He stressed, “Primary prevention (i.e. reducing exposure to cancer risk factors) is a vital strategy for reducing the risk of developing cancer. The Government has long been adopting a multipronged approach, including publicity, education, promotion, legislation and regulation, to encourage citizens to live a healthy lifestyle, such as a healthy diet, regular physical activities and maintenance of a healthy body weight and waist circumference, as well as avoidance of smoking and alcohol, to reduce the risks of contracting non-communicable diseases including cancer.”
At the meeting, members reviewed and discussed the progress of various cancer prevention and control measures, including:
Surveillance
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The Hong Kong Cancer Registry is responsible for local cancer surveillance work. Dedicated to recording and consolidating data on various types of cancer, the Registry assists the community in formulating, monitoring, and evaluating various cancer services through scientific data analysis. In recent years, apart from supporting the evaluation of the prevailing cancer screening programmes in Hong Kong (such as the Colorectal Cancer Screening Programme (CRCSP) and the Breast Cancer Screening Pilot Programme (BCSPP)), the Registry also ramps up the collection and compilation of more comprehensive cancer surveillance data, including the provision of complete and accurate stage-specific data on 10 prevalent cancers in Hong Kong, stage-specific analysis of the survival rate of nine cancers, as well as consolidation and release of the most common biomarkers on three cancers, thereby enabling various stakeholders to make accurate judgments and strengthen cancer prevention and control.
Prevention and Screening
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The Department of Health (DH) has long been promoting a healthy lifestyle as the primary strategy for cancer prevention. The DH makes every effort in stepping up public education related to cancers with a view to raising public awareness of cancer prevention and screening. Health education information and publicity materials are disseminated through different media platforms such as websites, television, radio, newspapers, magazines, and social media.
The CRCSP has been fully implemented since 2020 to subsidise asymptomatic Hong Kong residents aged 50 to 75 to undergo screening. As of last December, more than 426 000 eligible individuals joined the CRCSP. About 33 100 and 2 900 of these participants were diagnosed with colorectal adenoma and colorectal cancer respectively. Among the colorectal cancer cases detected under the CRCSP, about 57 per cent were of an early stage (i.e. stage II or below).
The Maternal and Child Health Centres (MCHCs) under the DH also offer subsidised cervical cancer screening to eligible women aged 25 to 64. Since April last year, the DH has adopted the human papillomavirus (HPV) testing with higher sensitivity in the cervical cancer screening services for eligible women. Moreover, as of last December, about 534 800 women aged 25 to 64 registered with the DH's Cervical Screening Information System, through which they can view their screening results and receive recommendations for further screening.
Separately, the DH launched the first phase of the BCSPP in the latter half of 2021 to provide breast cancer screening services for eligible women in a risk-based approach at its three Woman Health Centres, four MCHCs and 18 Elderly Health Centres. As of March 31 this year, 30 048 women aged 44 to 69 received assessment for the risk of developing breast cancer. Among them, 8 484 (28 per cent) were referred for mammography screening. The Government is currently gearing up for the next phase of breast cancer screening work and will announce the details in due course.
To tie in with the development of primary healthcare services, the Primary Healthcare Office (PHO) under the Health Bureau (HHB) also actively promotes the Life Course Preventive Care Plan through District Health Centres and family doctors to enhance public awareness of disease prevention and establishing a healthy lifestyle. The PHO published the Hong Kong Reference Framework for Life Course Preventive Care in Primary Healthcare last September, providing healthcare professionals with a set of comprehensive and evidence-based health guidelines. The Life Course Preventive Care Plan under the Reference Framework emphasises disease prevention and personalised needs. Personalised plans that focus on disease prevention are established according to factors including gender, age and family history, covering not only vaccination as well as prevention and management of chronic diseases but also cancer screening. As recommended by the DH, persons aged between 50 and 75 should undergo colorectal cancer screening, and may also receive screening for prostate, breast cancers and more according to personal risk factors. Meanwhile, starting from October 6 last year, only doctors enlisted in the Primary Care Directory are allowed to take part in various government-subsidised primary healthcare programmes (including a cancer screening programme).
Diagnosis, Treatment and Survivorship Care
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The Hospital Authority (HA) keeps improving the diagnostic services through a multidisciplinary-team-based approach to provide timely investigations and diagnosis for suspected cancer patients. The Kowloon West Cluster has piloted multidisciplinary diagnostic services for suspected lung cancer patients. The HA is exploring to expand the service to other clusters to benefit more patients.
In terms of treatment, the HA will have new linear accelerators installed in Pamela Youde Nethersole Eastern Hospital and Prince of Wales Hospital in 2024/25 to augment the capacity of radiotherapy service. Medical equipment for application in different clinical areas will be upgraded and acquired upon clinical needs, such as the Smart Treatment Planning System for radiotherapy.
The HA has also expanded the coverage of the Drug Formulary by incorporating new drugs for treating cancers and expanding the scope of clinical application of individual Special drugs. In addition, the HA is actively exploring collaboration with the private sector to refer paediatric oncology patients with specific indications for receiving proton beam therapy in a private hospital. As for the support to cancer survivors, the HA is gradually strengthening nursing and allied health care services according to the established service framework with a view to addressing the multiple needs of cancer survivors.
Research
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The HHB has long been supporting researches related to cancer prevention, diagnosis, treatment and survivorship through the Health and Medical Research Fund (HMRF), so as to formulate evidence-based health policies in a bid to reduce morbidity and mortality of cancer as well as improve patients' conditions and their quality of life. Since the Government's promulgation of the Cancer Strategy, the HMRF has supported 230 investigator-initiated research projects, 12 health promotion projects and 27 Research Fellowship Scheme projects, as well as multiple commissioned researches related to cancer and its risk factors, such as those evaluating the effectiveness of the CRCSP and the BCSPP.
Established in 2001 and chaired by the Secretary for Health, the CCC comprises cancer experts and doctors from the public and private sectors, academics and public health professionals. The CCC makes recommendations on the formulation of strategies for cancer prevention and control, while steering the direction of work in relation to cancer prevention and screening, treatment, surveillance and research, etc. The Cancer Expert Working Group on Cancer Prevention and Screening under the CCC regularly reviews international and local evidence and makes recommendations on cancer prevention and screening applicable to the local setting. In addition, the Hong Kong Cancer Registry, the HA and the Research and Data Analytics Office of the HHB oversee cancer surveillance, treatment and research respectively.
