Is WA ready for the projected surge in cancer cases? With the new bowel and lung cancer screening programs up and running, what is being done well, and what can be improved?
By Suzanne Harrison
It wasn’t until she had severe stomach pain that Cherie Salter presented to emergency in 2022. The now 55-year-old cannot believe she waited so long to get the right medical help for what was eventually diagnosed as stage 4 bowel cancer.
Cherie, a Badimia Yamatji Wadjak Ballardong Nyoongah woman who works for the Smith Family, started experiencing symptoms in her 40s, ignoring them for two to three years and putting it down to irritable bowel syndrome.
After the pain became unbearable, it was found the cancer had spread to other parts of her body. She has since undergone chemotherapy, surgery and radiotherapy.
Luckily, Cherie no longer has bowel cancer symptoms, is receiving the regular care she needs and has returned to work.
“There has been a lot of campaigning to get us tested with pap smears and mammograms, but we haven’t got to that stage with bowel cancer,” said Cherie, adding there is still a stigma attached to bowel-related testing.
“I was doing the pap smears and breast checks, but I didn’t have what I thought was typical bowel cancer symptoms. We’ve all heard the stories of prepping for a colonoscopy, and that can be embarrassing.”
Now, Cherie’s message is simple: do not ignore anything unusual when it comes to your bowel.
Surge in cases
Cherie’s message couldn’t come at a better time. Earlier this year, Cancer Council research in Australia showed more than 4.5 million new cancer cases are projected to be diagnosed between 2020 and 2044, putting a significant burden on the healthcare system.
The same research found nearly one in two (45%) Australians believe the country’s health system is unprepared for what will be a significant rise in cancer cases over the coming years.
Data showed that Australians were significantly concerned about their cancer risk, with seven in 10 surveyed saying they were worried about developing cancer in their lifetime.
While cancer risk increases with age, eight in 10 Australians aged 25-34 and more than seven in 10 Australians aged 35-49 are concerned about developing cancer in their future.
Cancer Council is calling on the Federal Government to commit to four key priorities to reduce the impact of cancer for all Australians.
These include tackling the rise of obesity to reduce the incidence of 13 types of cancer, investing in skin cancer prevention campaigns towards a future free from skin cancer, increasing participation in the National Bowel Screening Program, and providing equitable access to cancer care by reducing the financial burden through improved services and support.
More screen time
This data comes hot on the heels of the new National Lung Cancer Screening Program, introduced on July 1, targeting people considered to be at high risk in the hope of detecting cases early, before they become incurable.
RELATED: The National Lung Cancer Screening Program: a revolution in lung cancer
Lung cancer is the fifth most commonly diagnosed cancer in Australia, with about 15,100 cases diagnosed in 2024, according to the Australian Institute of Health (AIHW).
It is still the deadliest cancer of those most commonly diagnosed – just 26% of people survive past five years.
In WA, latest data suggests more than 1000 cases of lung cancer are diagnosed in the State every year, but many more cases could be going undiagnosed. It is expected that with the new screening program, more will be diagnosed at an earlier stage.
Yet Prof Fraser Brims, Consultant Respiratory Physician at Sir Charles Gairdner Hospital, said WA was well prepared to implement the program and deal with an increase in diagnoses.
One of the aims of the program, he says, is to target the hard-to-reach populations.
“Lung cancer is a disease of inequity and we know that rural and remote areas and Indigenous populations have higher rates,” he said.
As a result, WA will have its first national mobile low-dose CT scanner truck – commissioned through Heart of Australia – as of November. It will be on the road in predominantly northern WA.
In terms of what can be done better, Professor Brims notes the introduction of LUCAP, a patient-focused research group developing a national clinical-quality data platform for lung cancer that collects, analyses and reports on information.
This includes such things as the pace of screening, the type of tests done and how quickly people are treated.
“LUCAP maps our care pathways, collects data across different centres and compares it,” Prof Brims said.
“It enables physicians to monitor the impact of lung cancer screening, offering a real-time process across public hospitals, looking at numbers coming through, wait times for surgery and demand for CT scans.”
For example, lung cancer – or potential lung cancer – can be identified early, but if the system can’t process people in a timely enough manner to avoid it going beyond early stage by the time they go for treatment, it misses the point of screening, he said.
RELATED: Lung Cancer Screening program a game-changer for diagnosis
The roll-out of the screening program will pick up the pace on the awareness front gradually, and that every healthcare provider has a role in ensuring the message to prevent – especially around smoking cessation – is powerful.
“Everyone – not just GPs, even the receptionist – has a role to play in talking about smoking cessation. The more patients who hear that message, the better.”
Bowel screening updates
Meanwhile, Bowel Cancer Australia data shows 1716 Australians are diagnosed with the disease under age 50 each year. In response, the National Bowel Cancer Screening Program (NBCSP) recently lowered its screening age to adults aged 45 to 74, from 50 to 74.
RELATED: Red alert for lowering bowel screening age
Early statistics show that while there is still a way to go in participation, there has been some impact.
In June, AIHW reported that initial data showed 77,551 home kits were requested between July and December 2024 for eligible people aged 45–49.
Of the 6.3 million people invited to take part in screening between January 2022 and December 2023, there was a marginal increase in participation to 41.7% – up from 40% in 2022.
In November 2024, the Department of Health, Disability and Ageing said many healthcare providers were already issuing program kits directly to patients but encouraged more practices to bulk order test kits and speak to eligible patients about screening.
“To put into context how impactful talking about bowel screening with patients can be: if we can increase participation to 60%, over 84,000 lives could be saved by 2040,” the department said in a statement.
An allied approach
While the increases in cancer cases are cause for alarm, experts suggest the health system is in a good position to support these patients.
Associate Professor Kynan Feeney, Head of Department Oncology, Haematology and Palliative Care at St John of God Hospital Murdoch, is hopeful for the future, saying a multi-disciplinary approach to the projected surge in cancer cases is a way forward.
“As we’ve improved our treatments and patients survive for longer, we’ve become busier,” A/Prof Feeney said.
“We do have the foundations to support that busyness and increase in care, not just necessarily keeping people from death, but keeping them alive and well when they do survive.
“More and more we are saying that we can make a big difference, not only in quality of life but also their survival by non-medically directed therapies, such as improving diet, exercise, reducing alcohol consumption, no smoking.”
Utilising a multidisciplinary team can also help take the load off other physicians.
“For example, medical oncologists are not very well trained in dealing with some of the mental health issues when it comes to cancer patients. For some people, cancer can bring up other past traumas, which is why we have a clinical psychologist in our practice.”
When it comes to GPs, Melissa Ledger, Cancer Council WA Cancer Prevention and Research Director, told Medical Forum that with shared risk factors for several chronic conditions and myriad of other acute and chronic health issues, “discussing risk factors for cancer is an important part of a GP’s role”.
It’s estimated that about one third of cancers can be prevented, and risk can be modified, she said.
“Behavioural risk factors and all risk factors could form part of GP ‘preventive health’ consultations and patient advice.”
She adds that there are numerous opportunities for GPs and primary care professionals to upskill, from prevention to supportive and palliative care.
Cancer Council WA has delivered a primary care education project for the last 20 years, funded by Cancer Network WA.
Breast cancer funding
Amid the projected surge in cases and patients living better for longer, Breast Cancer Care WA (BCCWA) said it is vital patients and their families or carers are advised
on how to move forward with a healthier lifestyle after a diagnosis.
However, it faces a new challenge amid a rise in breast cancer cases – it is facing a funding challenge for the first time.
For 25 years BCCWA has provided specialist support across WA. In 2024, more than 1900 people and their families approached BCCWA, all provided free of charge.
Sally Dare from BCCWA said: “The incidence of breast cancer diagnoses among Australians is on the rise and the survival rate has increased to 92% for the 2016-2020 period.
“BCCWA helps ease pressure on time-constrained WA health services by offering ongoing, person-centred support and vital information to WA people navigating breast cancer.”
BCCWA spokesperson Jess Hicks told Medical Forum that the charity was hopeful that State government funding would come their way.
“For that whole 25 years, we’ve been able to fundraise ourselves, but now with the increasing numbers of cancer patients we’re seeking that extra support.”
“We receive 70% of our referrals from public and private hospitals. That demonstrates the critical gap we are filling.”
Talk about it
As for Cherie, she can’t speak highly enough about the care she has received, and continues to benefit from, at Joondalup Hospital.
“I no longer have shortness of breath, I have an amazing sense of relief that I can work in a job I love, be in the community and no one would know.
“That’s really helped me accept what is in my body and deal with my physical and mental health.”
Cherie discusses her experience publicly in a bid to help others who may feel too ashamed to admit they are worried.
“It’s better to be overly zealous than ignore things,” she said.
“Inform yourself about what the real symptoms are. Speak to your doctor, don’t just Google search. Be frank and honest with your GP. Insist on an investigation.”
As Cherie rightly concludes: “Let’s talk crap!”
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