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October is Breast Cancer Awareness month, marking in shades of pink its loud, clear and important message that breast cancer must be fought with personal vigilance and persistent effort on self-examination for early detection. Many events in town are held this month by charities and institutions to save women, improve the lives of those afflicted by the disease and spread the word about this condition that one day, hopefully, will be eradicated.

The number of new patients dealing with the illness has risen steadily since 1983, primarily because better diagnostic techniques have been available over the decades; the population has also expanded.

According to the Hong Kong Breast Cancer Foundation, breast cancer has become the most common cancer affecting women in Hong Kong over the past 20 years. Since 1993, annual diagnoses have almost tripled from 1,152 to 3,868 in 2014. On average, about 10 women are diagnosed with breast cancer every day and lifetime breast cancer risk is one in 16. In 2014, 57 percent of the women diagnosed with breast cancer were aged 40 to 59. The older the person, the higher the risk, although young people are of course not immune: indeed, the youngest case concerned a 20-year-old woman. Nowadays, more and more women find themselves dealing with this illness in their 30s.

As reported by this newspaper on September 15, women aged 35 or younger account for 10 to 15 percent of all breast cancer patients. On the Chinese mainland, the numbers are equally alarming; in 2015, 260,000 new breast cancer cases were reported in women of different age groups. Professor Shao Zhimin at Fudan University Shanghai Cancer Center confirmed there are several reasons for this increase. These include changes in lifestyle, living conditions, diets and urbanization. But new medical technology, early detection and enhanced treatment can contribute to recovery, with early detection being the key to successful treatment. The professor recommended that women aged 25 and older should have regular breast-cancer screenings. Women older than 40, on the other hand, should have routine mammograms to detect any anomalies and keep everything under control. While all this makes perfect sense, if we reflect on the reality in Hong Kong I cannot help but think that this is just not feasible for everyone.

Thus doctors advise women to self-check on a regular basis, and if a problem is suspected, it is imperative to follow this up with a professional checkup and ultrasound. If push comes to shove, a biopsy must be ordered and, depending on the gravity of the problem, other follow-ups and exams must ensue.

It is understandable that medical consultations and treatment can be costly but basic screening should rather count as a preventative action and should be free, or at least more affordable. Charities in Hong Kong, despite relying on donations and government aid, still charge a remarkable amount of money for ultrasound and biopsies when offering medical assistance. Most low-income households probably cannot afford them. Hong Kong should follow the model that is available in countries such as Italy and the United Kingdom, where basic screening is provided for approximately 10 euros ($12). Not only that: every year, every female citizen receives a reminder from the local council to be checked for both breast and cervical cancer. Pap smears should also be available at low cost if not free. Whilst cervical cancer might be less prevalent than breast cancer, the end result is just as devastating for the individual.

Breast cancer is also asymptomatic. It is considered to be a silent killer, as is cervical cancer. If a person is not in pain, it is unlikely that she will seek medical advice at a high cost just for a check. But a woman should not be put in a position where she has to consider whether she could afford basic screening or not. She should just be able to do it, regardless of her financial situation.

A functioning society exists when, among other things, its health care system is comprehensive, sustainable, and where the particularly vulnerable can receive added support from the government. Given our bulging financial reserves, there is no reason why Hong Kong cannot provide this vital medical safety net for all women in our society.

Finally, while it maybe a clever publicity strategy to designate October as cancer awareness month, it might be more effective for all stakeholders to try to raise the public awareness of this silent killer throughout the year since it obviously does not strike only during the "pink season" which marks October as cancer awareness month.

(HK Edition 10/30/2017 page10)