NSAC priorities in 2013

These include discussion about the future of Triple A screening (Abdominal Aortic Aneurysm) in New Zealand, the implications of a UK study into the effectiveness of breast screening, the introduction of new technologies, and clarifying the ongoing role and functions of the NSAC.

The NSAC advises the Ministry of Health on a range of issues related to screening, including its effectiveness, informed consent, variation in screening participation, health literacy, costs, and other considerations.

Ross Lawrenson, who is also Professor of Primary Care at Auckland University, expects debate to continue about the value and impact of screening for prostate cancer, as highlighted in a North & South magazine article entitled ‘The Unkindest Cut’ in April 2012.

“Our own research has shown that of the 350,000 Prostate Specific Antigen (PSA) tests done in New Zealand in 2011, 80 percent were screening tests and the remaining 20 percent either involved diagnostic tests in people with prostate problems or monitoring people with prostate cancer,” he says.

“Many of the screening tests were carried out in men aged over 70, and we know there are no clinical benefits to screening men over the age of 70.  However, there is the potential for harm if screening asymptomatic men in that age group then results in aggressive cancer treatment.  We need to consider these issues very carefully.”

Another topic requiring further discussion involves the UK Breast Screening Programme study of the effectiveness of breast screening, which highlighted over-diagnosis and over-treatment but also confirmed screening reduced breast cancer mortality.

“In New Zealand our biggest concern is closing the gap for Māori and Pacific women whose poor outcomes from breast cancer have been a much higher priority,” says Professor Lawrenson.

He is also interested in discussing the idea of population screening for Abdominal Aortic Aneurysm (AAA). He says although overseas studies have shown the potential to reduce the number of deaths from AAA, the value of introducing a population-based programme at a time of resource constraints and improving cardiovascular health in general, requires careful thought.

“As a country we also need to consider emerging issues such as genetic screening or the place of new technologies, and quality frameworks for screening. We need to be firmly focused on quality improvement across all our screening programmes.”

To find out more about the NSAC visit www.nsac.health.govt.nz.