AUSTRALIA: Cancer Funding Snub Under Fire

Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.

AUSTRALIA: Cancer Funding Snub Under Fire

Sydney Morning Herald (10.16.09) - Thursday, October 22, 2009
Julie Robotham

Australia's Medical Services Advisory Committee (MSAC) ruled recently that liquid-based cytology and computer-assisted LBC for cervical cancer screening are not cost-effective at current prices, and they should not be supported by public funding. LBC preserves cells in a liquid sample for screening instead of the sample being placed on a glass slide as with the conventional Pap smear, which is offered free through Australia's cervical screening program.

Some physicians are criticizing the committee's decision, saying MSAC preferred "outmoded technology" by overlooking LBC's advantage in preventing needless re-testing.

"For many women it would reduce the need for invasive and possibly unnecessary further investigations and treatment, with their attendant costs and stress," said Dr. Gabriele Medley, a spokesperson for the Royal College of Pathologists of Australia.

Australian research has found the $35 (US $32) ThinPrep LBC test detected abnormal cells more accurately than the regular Pap test. In addition, in LBC the sample can be preserved for further testing if abnormal cells are found, saving the woman from return visits.

MSAC determined that in comparison with the Pap, LBC and computer-assisted LBC are safe and as effective, but "not cost-effective at the price requested." MSAC also rejected funding for human papillomavirus testing, which would have cost $90 (US $83) per test but is less invasive than colposcopy. Research suggests that women found free of HPV by testing can safely forego screening for several years, saving money, said Neville Hacker, director of the Gynecological Cancer Center at the Royal Hospital for Women.

"I think we are way behind the times - we are doing screening too frequently and using outmoded technology," Hacker said.
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