Connecting stakeholders and co-ordinating care will help Australia build on its impressive progress in tackling the disease
Although more Australian women are surviving breast cancer than ever before, further progress in the country’s battle against the disease could be made with better co-ordination among the many stakeholders in research, treatment and the overall organisation of care. Although there is strong collaboration between NGOs, better co-ordination of funding streams would be beneficial, as would efforts to streamline data collection and sharing at a national level. Overall, improving connections between federal and state governments, public and private health systems, NGOs and public bodies, researchers and clinicians, and cancer specialists and GPs, will be key to building on the success of Australia’s breast cancer control programme.
These are among the key findings of Getting it all together: Connecting Australian breast cancer care, a new report from the Economist Intelligence Unit. The paper, based on a series of in-depth interviews with a range of experts working across the breast cancer field, provides a status report on Australia’s bid to control the disease. Putting the country’s breast cancer control programme in an international context, the report examines what Australia is doing well, where it still faces challenges and how experts think these might be overcome. It also includes a variety of “best-practice” case studies on innovative local, national and international initiatives.
Other key findings of the report include:
· Progress in early detection and treatment is impressive, but growing incidence demands continued focus. Headline mortality and survival figures for breast cancer in Australia have been steadily improving. This is due to the government’s commitment to evidence-based guidelines for the management of breast cancer treatment, robust funding, and a high degree of collaboration between organisations dedicated to fighting breast cancer. However, Australia’s own screening goals among target demographics have not yet been reached, and a rising incidence rate demands continued effort to maintain progress.
· Streamlining funding remains a challenge. A high degree of collaboration between breast cancer organisations across the field, from research to treatment and survivorship, together with a culture of multi-disciplinary care, has helped offset the inefficiencies of a complicated health system. However, there is no overall co-ordination of funding for initiatives related to breast cancer, inhibiting long-term investment. This also makes it tougher for NGOs, some of which question the long-term sustainability of their funding obligations.
· Better data co-ordination is a priority. Putting together evidence-based programmes demands quick access to comprehensive data sets. But it is far from easy to get sufficient national figures in Australia: data collection systems are incompatible, each of the states controls its own cancer registries and data applications can take months. There are also big gaps in the information on what happens to patients once they start treatment.
· Too little attention is being paid to prevention. Many think Australia (in common with many countries) pays too little attention overall to breast cancer prevention. Prevention will demand increasing focus as genetic risk profiling advances, particularly to fund follow-up studies on lifestyle and preventative intervention.
· Translating research into clinical practice and strengthening multi-disciplinary care are increasingly important. Genomic research leading to personalised treatments will put a greater emphasis on translating research into clinical practice, as is happening in major cancer research centres in Canada, the UK and the US. In Australia, translational research is now on most funders’ agendas, and new investments will help facilitate closer links between scientists and clinicians. Regarding treatment, there is scope for even greater integration of research with clinical practice, and for more aspects of treatment and post-treatment care to be co-ordinated.
· Some population groups are doing worse than others. As with many other diseases, breast cancer sufferers in remote and rural regions of Australia can expect worse outcomes. This is because cancer care services tend to be centralised in the cities: long travel times delay diagnosis, meaning sufferers are less likely to identify the disease early. Rural and remote communities also tend to be poorer and have greater incidence of associated lifestyle risks like smoking and obesity. Some innovative NGO-led community programmes have made headway in reaching these regions, but disparities remain.
Getting it all together: Connecting Australian breast cancer care
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