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Cancer in Australia

Introduction to Cancer in Australia

An increase in the incidence rate of cancer in Australia has raised grave concern for addressing the need for analysis of the government implemented polices in various state as well as national run programs for prevention and education of cancer. This report will entail needs assessment for cancer control service and understanding of best approaches for needs analysis. It shall also briefly provide statistics of cancer prevalence in Australia based on evidence-based literature till the year 2017 and SWOT analysis of cancer prevention programs by the government implemented by the Australian government.

Needs Assessment for Cancer Control

Statistics (Australian Institute of Health and Welfare, 2018).

  • Commonly occurring cancers in Australia are the prostate cancer, breast cancer (primarily in-situ), bowel or colorectal cancers and lastly lung cancer.The incidence of these five cancers contributes to nearly 60% of all cancers which are diagnosed in Australia.
  • Nearly 434,000 individuals were diagnosed with non-melanoma skin cancer in the year 2008, in Australia. 
  • Approximately, 679 individuals died due to non-melanoma skin cancer, in the year 2016 in Australia.
  • The burden of cost borne by the healthcare system for Cancer is more than $4.5 billion, which is 7 per cent.
  • Australian government provided a generous funding of about $252 million was provided to help scientists and doctors to continue their researches and to run community health and education or other programs for the benefit of cancer patients (Fox et al., 2017).
  • In the year 2017, new cases with diagnosis of cancer are estimated to be around 145,000 in Australia and the expected surge in the numbers by 2020, to about 150,000 cancer patients.
  • Every second person in Australia, who is above the age of 85 years, is diagnosed with cancer.
  • The leading of death in Australia is Cancer, effecting the lives of nearly 50,000 people. The mortality rate of cancer was 50,000 deaths in the year 2019. 
  • Cancer was also the second most cause of increased mortality in Australia in the year 2014 accounting for about 3 in 10 deaths. Nonetheless, the rate of death due to cancer has lowered since then, due to increase in healthcare facility and improved evidence-based research. The number of deaths per 100,000 people has decreased to more than 24%. In contrast to the year 1982, when the survival rate of cancer patients was about 50%, at present, nearly 7 in 10 Australians have the chance to survive for 5 more years after the diagnosis of cancer has been established, and most often, the survival rate of cancer is as high as 90 per cent. (Australian Institute of Health and Welfare, 2018)

Literature Review of Cancer in Australia

The definition of Cancer control encompasses the actions which help to decrease the burden of cancer on the healthcare system by impacting the community. It involves various factors of care such as early detection and intervention, decreasing risk factors, providing adequate education and increasing patient or community awareness; using evidence-based researches to help the patients to obtain better outcomes. bridging the gap between the aboriginal and non-aboriginal communities in terms of access of medical health care facilities and decreasing the disparity in treatment for all people in Australia by making healthcare affordable (Fox et al., 2017).

The healthcare system of Australia is very complex. The Federal Government of Australia pays the healthcare system such as the hospital through the medical services as per the established Medicare system. It also took responsibility for conducting screenings and routine mammograms for women who are at high risk of developing breast or cervical cancer through government cancer screening program. The government of Australia also provides benefits to cancer patients under the “Pharmaceutical Benefits Scheme”, and few other government’s funded schemes cover radiotherapy services, palliative as well as aged care. The Nation’s State and Territory Governments are responsible for providing effective healthcare services to the Australian population and they are publicly funded with private services as well as by various health insurance companies. The “Cancer care and cancer control”, has generous funding and support from non-government as well as voluntary non-profit organizations, till the year 2017, especially pertaining to the aspects such as providing education, counselling, financial help to the carers and families of the cancer patients for the purpose of the treatment as well as the for living in case of the patients who were primary bread winners of the family (Innes-Walker & Edwards, 2013).

The report shared by Health For All Australians endorses few suggestions and goals pertaining to the 5 primary cancers which contribute to increase mortality in Australia (Dasgupta et al., 2017). These recommendations and strategies proposed by the “Australian Cancer Society” is a fragment of the National Cancer Prevention Policy for Australia. The suggested strategies included: 1) Routine mammograms and screening programs for breast early detection breast cancer. 2) Establishing a population-based “cervical cancer screening program” which includes funding for reaching out to the target population at regular intervals; ensuring routine follow ups of the patient, assurance of quality of care provided, epidemiological research along with effective evaluation of the program (Fox et al, 2017). Utilizing “call and recall systems” to increase the participation of eligible women for the purpose of research based on cervical screening 4)Increasing means for education and continuous education programs for public as well as professions in the field of cancer (Fox et al., 2017), 5) Enhancing the options for collecting of smears. 6) Suggestions for skin cancer included encouraging people to have less exposure to sun from 10 am to 2 pm; adequate use of sunscreen while being outdoors for work; decreasing in the tax on effective products such as medicated sunscreen lotion and increasing the recommendations of the same by the pharma companies or the healthcare providers (Petersen &Alexander, 2013).

Best Needs Analysis Approach for ‘Cancer Control Service’

The assessment of needs approach are basically categorized into three, the first is the perceived needs, which is defined by the thoughts of the people regarding their needs; the expressed need, which is demonstrated by the services which people use, and third category is the relative needs which are those needs which are absolute needs and vary depending upon the circumstances. For the purpose of “cancer control service”, the needs analysis approach of expressed needs is the best approach, because in healthcare, the use of services is dependent on the needs expressed by the patients and the medical symptoms they produce (Mosher et al., 2013). The needs analysis helps in identifying the gaps to be addressed for providing quality of healthcare service, and is gathered by various multidisciplinary approach such as involvement of a medical oncologists, radio oncologist, nurse, psychologist, nutritionist, physical therapist in determining different needs of the cancer patients and providing holistic care. At the national level this approach can be used by conducting an evidence-based epidemiological research in women cancer survivors and asking them if their needs have been met (Mosher et al., 2013). The data collected should be analyzed and reveal a few basic needs on cancer patients which will help in guiding the healthcare community to take steps in the right direction for reforming the manner in which the care is delivered and also help train the new medical nurses and graduates to develop the same skills (Wilson et al., 2018). 

Challenges Faced in Undertaking the Needs Analysis at Policy, Inter‐disciplinary and Generic Levels

The challenges with undertaking needs analysis is lack of adequate time. The cancer patients struggle usually struggle with mental issues, such as depression and anxiety which comes with the news of cancer diagnosis. They have very less time for surveys and interviews as they juggle between various therapy sessions and mood swings and most often are burdened with feelings of tiredness and fatigues as a result of treatments and their side effects. It causes notable inconsistency in establishing effective communication with the patients. Thus, at generic and inter-disciplinary levels the factors such as patient behavior, lack of time, resources all encompasses challenges attached to the field of cancer control, whereas, at the policy level the challenge is mainly time taken for policy makers to conduct relevant evidence-based researchers for project planning and implementation. (Oishi & Murtagh, 2014).

SWOT Analysis of Cancer Control Program

Strengths: The program is primarily run by the government, which means there is no lack of funding and resources for meeting the pressing needs of the cancer community. There is a huge stakeholder involvement and efficacy of work is ensured to complete the cancer control program as per the scheduled timing. The responsibility of routine follow-ups and screening of the elderly population as well as individuals who are at higher risk of cancer; will reduce the risk of developing cancer (Jacklyn et al., 2017; Stevens & Gillam, 1998).

Weaknesses: The time taken for implementing the project plan is too much as it involves bringing all the stakeholders to work in a collaborative manner; doing the research and forming a plan to be executed; collecting and allocation of the resources; time taken for policy making. Secondly, a lack of adequate access to medical facilities in the rural and remote areas (Kirshbaum et al., 2017).

Opportunities: This provides an opportunity for the government to interact with the community directly and understanding the needs and increasing the level of awareness and risk factors pertaining to cancer.

Threats: The threats include changes in the government leaders and economic situations of the country. External factors such as industrialization which pollute the air by cancer-causing elements, lack of efficiency of governmental policies to control cancer risk such as smoking (Palermo et al., 2012). Internal factors involved apprehension of the people to undertake screening out of natural fear of diagnosis of cancer.

Program Priorities

These include identifying the needs of the patients, working with the cancer patients at the grass-root level to ensure they have access to the medical facilities and insurance coverage to sustain the financial need in the cancer treatment by funding obtained from the governmental as well as non-profit organizations. The priorities also include increasing the awareness of the community through the community healthcare plans and state or local council levels and educate them for the prevention and management of cancer. (Jacklyn et al., 2019)

Strengths

Routine Screening

Increased coverage of insurance

Stakeholder involvement

Weaknesses

Lack of adequate medical facilities for rural and remote populations

Time consuming approaches

Opportunities

Mandatory screening

Access of medical facilities

Making healthcare affordable for all population

Threats

Reluctancy u=in undertaking screening

Economy of the nation to provide sufficient resources

Lack of education in the population

Conclusion on Cancer in Australia

Various government implemented policies and procedures are in place for addressing the national need of preventing the risk of cancer in Australia. These include community health programs, for increasing awareness and education of cancer. The majority of high-risk cancers in Australia are prostate cancer, breast cancer (primarily in-situ), bowel or colorectal cancers and lastly lung cancer. National Cancer Prevention Policy for Australia  has provided many efforts in the direction of implementing strategies such as environmental control for pollutants and regular cancer screening of individuals who are at high risk of cancer to reduce the burden on healthcare.

References for Cancer in Australia

Australian Institute of Health and Welfare. (2018). Cancer in Australia: Actual incidence data from 1982 to 2013 and mortality data from 1982 to 2014 with projections to 2017. Asia‐Pacific Journal of Clinical Oncology14(1), 5-15

Dasgupta, P., Youl, P. H., Aitken, J. F., Turrell, G., & Baade, P. (2017). Geographical differences in risk of advanced breast cancer: Limited evidence for reductions over time, Queensland, Australia 1997–2014. The Breast36, 60-66.

Fox, W., Powell, M., Hyland, V., & Honeyball, F. (2017). Supportive care for women with breast cancer living in rural Australia. In Cancer Forum (Vol. 41, No. 1, p. 62). The Cancer Council Australia.

Innes-Walker, K; &Edwards, H (2013): A wound management education and training needs analysis of health consumers and the relevant health workforce and stocktake of available education and training activities and resources Wound Practice & Research: Journal of the Australian Wound Management Association, 21(3), 104-109. Retrieved from http://www.awma.com.au/journal/2103_01.pdf

Jacklyn, G., McGeechan, K., Irwig, L., Houssami, N., Morrell, S., Bell, K., & Barratt, A. (2017). Trends in stage-specific breast cancer incidence in New South Wales, Australia: insights into the effects of 25 years of screening mammography. Breast cancer research and treatment166(3), 843-854.

Jung, K. Y. K., Shadbolt, B., & Rezo, A. (2019). Temporal impact of the publication of guidelines and randomised evidence on the adoption of hypofractionated whole breast radiotherapy for early‐stage breast cancer. Journal of medical imaging and radiation oncology63(4), 530-537.

Kirshbaum, M. N., Dent, J., Stephenson, J., Topping, A. E., Allinson, V., McCoy, M., & Brayford, S. (2017). Open access follow‐up care for early breast cancer: a randomised controlled quality of life analysis. European journal of cancer care26(4), e12577.

Mahony, J., Masters, H., Townsend, J., Hagerty, F., Fodero, L., Scuteri, J., & Doromal, D. (2019). The impact of breast care nurses: An evaluation of the mcgrath foundation's breast care nurse initiative. Asia-Pacific journal of oncology nursing6(1), 28.

McFarland, ML; Nicholson, JM; Oldenburg, B; Dwyer, SB (1999) Mental health interventions in the primary school setting: perceived facilitators, barriers and needs: Health Promotion Journal of Australia, Vol. 9(2), 96-104

Mosher, C. E., Jaynes, H. A., Hanna, N., & Ostroff, J. S. (2013). Distressed family caregivers of lung cancer patients: an examination of psychosocial and practical challenges. Supportive Care in Cancer21(2), 431-437.

Murray, Scott A (1999) Experiences with "rapid appraisal" in primary care: Involving the public in assessing health needs, orientating staff, and educating medical students, British Medical Journal, International edition7181 (Feb 13): 440-444. Retrieved from http://www.bmj.com/content/318/7181/440

Oishi, A., & Murtagh, F. E. (2014). The challenges of uncertainty and interprofessional collaboration in palliative care for non-cancer patients in the community: a systematic review of views from patients, carers and health-care professionals. Palliative medicine28(9), 1081-1098.

Palermo, C; Robinson, C; Robertson, K; & Hii, S (2012) Approaches for prioritising the nutritional needs of refugee communities : Australian Journal of Primary Health, 18 (1), 11-16. Retrieved from the Torrens University Australia Library databases.

Petersen, D. and Alexander, G. (2013). Needs assessment in public health: A practical guide for students and professionals. (2nd ed.). New York. Springer Chapters 1-3.

Renault, V (n.d.) SWOT analysis, Strengths, Opportunities, Weaknesses Threats.

Stevens A &, Gillam S (1998). Needs assessment: From theory to practice. British Medical Journal, 316(7142), 1448–1452. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1113121/

Wilson, L. F., Antonsson, A., Green, A. C., Jordan, S. J., Kendall, B. J., Nagle, C. M. & Whiteman, D. C. (2018). How many cancer cases and deaths are potentially preventable? Estimates for Australia in 2013. International journal of cancer142(4), 691-701.

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