Budget delivers improved cervical and breast cancer screening

• Budget 2021 funds a more effective cervical screening test to help reduce cervical cancer rates
• A new breast screening system that can proactively identify and enrol eligible women to reach 271,000 more people who aren’t currently in the programme.

Budget 2021 delivers a better cervical screening test and a major upgrade of the breast cancer screening system to reduce the number of people who die from the two diseases.

“We are able to invest in and implement changes in health that will deliver for all New Zealanders thanks to our economy performing better than forecast because of the Government’s successful management of COVID-19,” Health Minister Andrew Little said, in a pre-Budget announcement.

“This is a recovery budget. The Budget will continue to focus on securing our recovery while making investments that improve the lives of New Zealanders.

“In the last three Budgets, we have made significant investments in health including delivering the biggest funding boost to maternity care in a decade. Our investment today builds on this so we can continue to address some of the country’s long-standing issues,” Andrew Little said.

“Every year, about 160 women develop cervical cancer and about 50 die from it. This is a tragedy as almost all cases are preventable or can be treated if they’re found at an early stage,” Associate Health Minister (Women’s Health) Dr Ayesha Verrall said.

“While our National Cervical Screening Programme has reduced incidence and death rates for cervical cancer by more than half since 1990, we know that only 61 percent of eligible wāhine Māori access it. There are many reasons for this including the time, cost and whakamā associated with taking the smear test.

“The persistent inequities around cervical cancer has been one of the long-standing issues in women’s health.

“That’s why Budget 21’s investment of up to $53 million to complete the design of and implement a new test for humanpapillomavirus (HPV), the cause of 99 percent of cervical cancers will make a real difference.

“The new test, which will replace the current smear test for the 1.4 million eligible women aged 25-69 years old, is a simple and quick swab that women can choose to do themselves. This will help to reduce the barriers to getting screened.

“Clinical modelling predicts the move to HPV screening will prevent about 400 additional cervical cancers over 17 years and will save around 138 additional lives. Around a third of the cases prevented and lives saved will be wāhine Māori.

“HPV testing, which is in place in Australia, the United Kingdom, Ireland and several other European countries, is also shown to be more effective so women who test negative only need to be screened every five years, not every three years as is currently the case.

“The investment also funds a new IT system which enables the programme change and supports the workforce to continue to deliver a safe, high-quality programme.

“The upcoming changes will be fully rolled out from 2023 and deliver on the Government’s priority to lay the foundations for a better future. However, it is really important that women who are due for screening continue to follow the existing process rather than waiting for the new test,” Dr Ayesha Verrall said.

Breast cancer screening

Each year in New Zealand, approximately 3,200 people are diagnosed with breast cancer and there are around 600 deaths from breast cancer.  The national breast screening programme, BreastScreen Aotearoa (BSA), provides free mammography screening every two years to women aged 45 to 69 who have no symptoms of breast cancer.

“The existing system operates as an ‘opt-in’ model, where women choose to enrol for breast screening via their GP or by calling a 0800 number. This model relies on women knowing they are eligible for free breast screening and making an appointment themselves,” Dr Ayesha Verrall said.

“The current ageing IT infrastructure puts the programme at risk. It lacks the flexibility to be easily upgraded to meet the needs of the community, and is no longer supported well by vendors. That’s why, in Budget 21, we have invested up to $55.6 million in a major upgrade of the technology, and another $10 million is earmarked to match population growth and catch up on breast screens missed due to COVID-19 lockdowns.

“The new technology will better equip the programme to reach the 271,000 women who are eligible to access breast screening but are not currently being screened, by being able to directly invite them and run targeted campaigns. When women are offered an appointment, they can choose to participate or ask to opt-out.

“With more Māori and Pacific women dying from breast cancer compared with non-Māori and non-Pacific women, the new system will allow BSA to identify priority group women who may not already be part of the programme.

“The Government is committed to improving health outcomes for our hard to reach communities and this is an important step in making that happen.

“The Government already invests more than $60 million a year on providing breast screening services around the country. By boosting our investment, we will save even more lives,” Dr Ayesha Verrall said.

The new system will be up and running in the next two years.