News in brief: Cancer treatment rate down by 9% due to pandemic; Expert perspectives on pancreatic cancer; Tobacco retail ban is next step for smoke-free Australia

Cancer treatment rate down by 9% due to pandemic

The COVID-19 pandemic resulted in an 8% reduction in cancer investigations and a 9% decrease in cancer treatment services in 2020, Medicare figures show.

A review of MBS data for 2020 showed there were 163,595 fewer cancer-related investigations compared to 2019. The greatest reductions were seen for colorectal cancer (13% lower), liver cancer (12% lower), lung cancer (9% lower), prostate cancer (7% lower), and stomach and pancreatic cancers combined (6% lower).

Investigations for breast cancer (4% lower) and uterine cancer (2% higher) were least affected.

Reductions in treatment (surgery and non-surgery) were greatest for breast cancer (6% lower), melanoma skin cancers (14% lower), pancreatic cancer (7% lower), and gynaecological cancers, cervical, ovarian, uterine, vaginal, and vulval combined (8% lower).

Treatments for lung cancer (2% higher), liver cancer (4% higher) an, prostate cancer (2% lower) were least affected by the pandemic, according to figures published by  Cancer Australia.

Expert perspectives on pancreatic cancer

Advances are being made in the treatment of pancreatic cancer in Australia, but challenges remain due to the high proportion of patients diagnosed at advanced stages and the limited treatment options, according to a new paper on expert perspectives from the Australasian Gastrointestinal Trials Group (AGITG)

The review notes that only about 20% of patients with pancreatic cancer are diagnosed with potentially curable disease.  It advises that mFOLFIRINOX is the preferred standard of care adjuvant chemotherapy for suitably fit patients with resected pancreatic ductal adenocarcinoma.

The review notes that while a move towards neoadjuvant therapy may improve resectability and survival rates, more robust evidence is still required. Similarly there has been only limited progress in advanced stage disease. Variation in defining resectable, borderline resectable and locally advanced disease adds complexity to interpretation of the data.

Genomic testing  may improve treatment by identifying subgroups of patients who may benefit from matched targeted therapy, such as PARPi for BRCA1/2 mutations, but the applications only in small numbers of patients.

“Incremental progress is being made in systemic therapies though more research is required to achieve significant progress,” the perspective concludes.

Tobacco retail ban is next step for smoke-free Australia

The government must set an ‘end date’ to phase out retail sales of tobacco altogether if it is to meet its goal of reducing smoking to below 5% by 2030, public health advocates say.

Writing in the MJA, Associate Professor Coral Gartner of the University of Queensland says the continuing availability of tobacco from retail outlets normalises smoking as a behaviour for young people and the only realistic action plan to reduce consumption is to reduce the number of retail outlets.

The authors say industry self‐regulation and other voluntary approaches will not reduce tobacco retailing, and there is a need to adopt approaches such as a restricting sales to a limited number of licensed dealers or putting tobacco on prescription.

Setting an end date for tobacco sales will also focus efforts on smoking cessation and force the government to plan for an end to tobacco tax revenue, they write.

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