A modelled evaluation of the impact of COVID-19 on breast, bowel, and cervical cancer screening programmes in Australia.

Australia introduced COVID-19 infection prevention and control measures in early 2020. To help prepare health services, the Australian Government Department of Health commissioned a modelled evaluation of the impact of disruptions to population breast, bowel, and cervical cancer screening programmes on cancer outcomes and cancer services. We used the Policy1 modelling platforms to predict outcomes for potential disruptions to cancer screening participation, covering periods of 3, 6, 9, and 12 mo. We estimated missed screens, clinical outcomes (cancer incidence, tumour staging), and various diagnostic service impacts. We found that a 12-mo screening disruption would reduce breast cancer diagnoses (9.3% population-level reduction over 2020-2021) and colorectal cancer (up to 12.1% reduction over 2020-21), and increase cervical cancer diagnoses (up to 3.6% over 2020-2022), with upstaging expected for these cancer types (2, 1.4, and 6.8% for breast, cervical, and colorectal cancers, respectively). Findings for 6-12-mo disruption scenarios illustrate that maintaining screening participation is critical to preventing an increase in the burden of cancer at a population level. We provide programme-specific insights into which outcomes are expected to change, when changes are likely to become apparent, and likely downstream impacts. This evaluation provided evidence to guide decision-making for screening programmes and emphasises the ongoing benefits of maintaining screening in the face of potential future disruptions.

Interview with the Hon. Dr Michael Wooldridge: tobacco control was the best buy in health then and it's still the best buy now.

The late 1990s marked a turning point for tobacco control in Australia. In March 1996, the Liberal-National Coalition won government after 13 years of Labor rule. Prime Minister John Howard had campaigned on cutting expenditure, and had long been a proponent of small government and the private sector. Yet within 2 years of taking office, the Howard Government funded Australia's first big budget National Tobacco Campaign and commenced a review of the Tobacco Advertising Prohibition Act 1992 to phase out industry sponsorship of international sporting events. The Honourable Dr Michael Wooldridge, Minister for Health from 1996 to his retirement from politics in 2001, reflects on how these reforms to tobacco control were achieved and how the public health community can best engage with policy makers to advocate for reform. He stresses the importance of public health not being defined by ideology, and that politicians must be scientifically well informed and supported in doing what is in the nation's best interest for public health. He assesses the current state of play and argues more investment in tobacco control is needed today, suggesting it remains the "best buy" in health.