New breast check plan under fire

By MARTIN JOHNSTON health reporter



Some women will lie about their medical history to get around delays and restrictions in obtaining state-paid breast screening, says the Breast Cancer Foundation.

"I wouldn't advise them to lie," foundation medical committee chairwoman Belinda Scott said yesterday.

"But then again, if they don't have any money, that would be a good way to do it [access free mammograms]," the Auckland breast surgeon said.

The Government offered free screening every two years to women aged 50 to 64 in its breast cancer screening programme, but on July 1 announced the gradual widening of the scheme to women aged 45 to 69.

This will nearly double the size of the programme, adding an extra 200,000 or more clients.

But because of a lack of trained staff and equipment, and the need to maintain its quality, the programme cannot start screening all eligible women immediately.

Women who dropped out after turning 65 will be the first in, being recalled when their next mammogram is due.

National Party health spokeswoman Lynda Scott said yesterday that some women wanting to join the programme would have to wait at least two years for their first free mammogram if they had paid for one in the preceding year.

She said this was explained in a letter the state-funded screening programme sent to GPs last week.

Many women under 50 paid for their own yearly mammograms and would continue to do so because under the Government's criteria for its widened scheme they would be excluded.

"This is blatant discrimination. The Minister of Health should encourage people to look after their own health, not punish them," said Lynda Scott.

The foundation's website recommends two-yearly mammograms for women over 50, in whom two-thirds of breast cancer cases occur, but yearly, "on the recommendation of your doctor", for those aged 40 to 49. A quarter of breast cancer cases are in this age group, but the tumours tend to grow faster in women under 50.

The minister, Annette King, last night defended the expanded scheme, saying: "It's two-yearly based on the [medical] evidence we've got."

She also appealed to women not to lie, but said, "I can't do anything about it if they do".

Belinda Scott, who acknowledged that extra staff and equipment could not be added instantly, said it would have been more open of the Government to have withheld screening from 45- to 49-year-olds until next July, as was recommended by its breast screening advisory group.

Instead, the Government had announced that these women would be offered screening as soon as capacity was available.

"The women will lie. Why should you tell them you had a mammogram last year. Why not ring up and say, 'I would like a free mammogram please.' You don't have to tell them you had one last year, do you?

"So you go every two years for your free one and in between you hop out and get another one. That will absolutely ruin the statistics for breast screening."

Ms King said she had not covered up information in her announcement. "I have been absolutely open about what we can do and can't do."


MAMMOGRAMS

More than 2000 New Zealand women are diagnosed with breast cancer each year and about 650 die from it.

Mammograms, which cost private payers about $100, are specialised breast x-rays.

The Government has nearly doubled the size of the screening programme but cannot screen all eligible women immediately.