Australia Lung cancer screening program Launched on July 1, and indicates real progress and opportunities.
It goals to cut back the number of people that die from lung cancer who usually offer low -dose CT scan to smokers, and people who have left. The purpose is to detect and treat it even before the cancer spread.
But the design of this program could cause further damage to individuals with Aboriginal and Taurus Street Islander, that are disproportionately affected by lung cancer.
So Australia's first latest cancer screening program in almost 20 years prevents health inequality relatively than health inequality Addressed to them.
Lung cancer is a special burden
Lung cancer is the very best Common cancer And The most important cause of cancer death For the people of the ancestral and Taurus Street Islander.
People with Aboriginal and Taurus Street Islander are prone to diagnose lung cancer 2.1 times higher, and are prone to die 1.8 times more, Comparison with Non -desi Australian.
People of Aboriginal and Taurus Street Islander usually tend to diagnose lung cancer in a Underage Compared to non -desi Australians.
It may be very essential for people of Aborigenal and Taurus Street Islanders to know the broader context of lung cancer risk.
The people of the ancestral and Taurus Street Islander have been Paid in tobacco rations Instead of being excluded from the economic and health systems, and being targeted by the marketing of the tobacco industry, as a substitute of wages until the Sixties.
Desi -led tobacco control and smoking programs, similar to Dealing with desi smoking In this system, I actually have made significant progress Reducing smoking rates. Are desi community To guide the resistance Damage to the tobacco industry.
However, individuals with Aborigenal and Taurus Street Islanders face major obstacles to lung cancer screening. This is very in rural and distant areas where access to GPS, Radiology services and culturally secure care Is arapen.
Lung cancer screening needs to be calculated
Initially, the lung cancer screening program was designed with one Low -screening age For people of Aboriginal and Taurus Street Islanders-50 years for non-indigenous Australian residents, 50 years in comparison with 55 years. Earlier and lung cancer was felt than the high risk of cancer.
However, the Medical Services Advisory Committee, chargeable for assessing applications for public financing, Removed this risk -based distinction. Now 50-70 years of general age is eligible.
This is a change toward equality (uniform) with equity. In health, treating everyone equally deepens inequality.
On the contrary, most of the public health programs are striving for equity and reflect the assorted needs of individuals of Aborigenal and Taurus Street Islanders. For example, Checking heart health And Many vaccines At a young age, Aborigenal and Taurus Street Islands are offered to people.
There are also potential consequences to cut back the screening age by 55 (as is definitely intended) for non -desi Australian residents. Cancer Australian Cancer Australia Report Warn that it would offer a positive balance of advantages and drawbacks, nor would it not be cost -effective.
In this low -risk population, it will possibly increase the probabilities of detecting nodles of the rising lungs slowly, that are unlikely to be damaged. This could cause unnecessary tests and procedures, anxiety, psychological anxiety, excessiveness and even harm.
Although people on the Aboriginal and Taurus Street Islander might also experience these potential disadvantages, the upper risk of lung cancer signifies that the potential good thing about initial detection is way greater than these risks.
Let's call it what it's – structural racism
Therefore, the standards of existing qualifications increase the capability of low -risk groups. Nevertheless, it ignores the high risk of individuals with the ancestral and Taurus Street Islander and the general effects of distant, limited access to health services and other health conditions.
This decision significantly increases the number of individuals accessing this system. Although it could look equal at the extent, it's vulnerable to misunderstanding of a limited health system resource, especially within the health system than ever.
This is a transparent example of structural racism – when policies that look like neutral maintain long -standing inequality, and reinforces the losses.
It is parallel to the concerns raised within the United States. There screening guidelines there Has been criticized Failure to calculate high rates of lung cancer in African Americans.
What should we do next?
If we're serious concerning the commitment of equity in cancer results – as described in Australian Cancer Plan And Ancestral and Taurus Street Island Cancer Plan – We must ensure that screening policies don't inadvertently expand inequality.
We must revisit who's eligible for screening and the way the eligibility is set. This means not only to think about the history of age and smoking, but other aspects similar to the family history of cancer.
This might also mean that the chance of lung cancer is predicted using models PLCOM2012 Risk Prediction Model. However, this particular model has not been verified within the people of Aborigenal and Taurus Street Islander, which requires priority.
Instead, the Medical Services Advisory Committee has preferred the identical screening age for everybody – administrative simplicity The more sensitive way To evaluate the danger.
We must prioritize individuals with Aboriginal and Taurus Street Islander over the weightlist and follow -up screening, and strengthen the cultural safety of services.
We must ensure strong data collection and reporting to guage the screening program. The diagnosis must be evaluated whether this system provides equal access and results, in addition to effectiveness, safety and value.
All these steps are essential to people of Aborigenal and Taurus Street Elinders to alleviate excessive burden of lung cancer and maintain more equity and health right than administrative simplicity.