Author Archives: hksar gov

     Following is a question by the Hon Holden Chow and a written reply by the Secretary for Development, Mr Michael Wong, in the Legislative Council today (November 14):   Question:        It is no… read more

     Following is a question by the Hon Tanya Chan and a written reply by the Secretary for Transport and Housing, Mr Frank Chan Fan, in the Legislative Council today (November 14):

Question:

     The land needed for the operation of the Hong Kong Section of the Guangzhou-Shenzhen-Hong Kong Express Rail Link (XRL) and the related interests have been vested in the Kowloon-Canton Railway Corporation (KCRC) by the Government. KCRC has granted the MTR Corporation Limited (MTRCL) a concession to operate XRL under a supplemental agreement to the service concession agreement (SSCA). On August 23 this year, the Government submitted to the Panel on Transport of this Council a paper on the operating arrangements for XRL (the Paper), and MTRCL issued, on the same day, an announcement explaining the relevant arrangements (the Announcement). Details of the operating arrangements for XRL include: (i) the average daily patronage (patronage) forecast for XRL in 2018 is 80 100 (set out in Annex 2 to the Paper), (ii) the projected operating profit and operating margins of XRL based on the patronage forecasts in Annex 2 to the Paper are set out in Annex 5 to the Paper, (iii) SSCA has provided for a “Patronage Cap-and-Collar Mechanism”, i.e. if the actual patronage deviates from the projected patronage by more than 15 per cent, MTRCL and KCRC will bear the risk or share the return according to a specified ratio, (iv) the total amount of Additional Concession Payments to be paid by MTRCL to KCRC over the ten-year concession period will be a net of $2.7 billion, which comprises an amount of $10.7 billion to be paid by MTRCL to KCRC, and an amount of around $8 billion to be paid by KCRC to MTRCL, and (v) SSCA provides that the Additional Concession Payments will be paid in the form of “fixed annual payments” and “variable annual payments”. In this connection, will the Government inform this Council:

(1) whether it knows the daily patronage of XRL since its commissioning on September 23 this year, with a tabular breakdown by whether the passengers were (i) Hong Kong residents, (ii) business visitors, and (iii) travelling northbound or southbound;

(2) whether the patronage forecasts adopted in SSCA (the former) are consistent with the patronage forecasts in Annex 2 to the Paper (the latter); if not,

(i) set out the former in a table of the same format as that in Annex 2 to the Paper; if such figures may not be disclosed, whether the patronage forecasts for 2018, 2021 and 2031 in SSCA are lower than the corresponding figures in Annex 2 to the Paper, as well as of a rough estimate of the extent of the difference between the two;

(ii) of the method for arriving at the former and the reasons for adopting such a method;

(iii) of the purpose and effect of setting out in Annex 2 to the Paper patronage forecasts which are different from those in SSCA;

(iv) of the relation between these two sets of figures;

(v) of the reasons why an account of the difference between the two was not given in the Paper; and

(vi) of XRL’s projected operating profit and operating margins based on the former (set out in a table of the same format as that in Annex 5 to the Paper); if such figures may not be disclosed, whether XRL’s projected operating profit and operating margins based on the former are lower than the projected figures in Annex 5 to the Paper and whether they are positive figures, as well as of a rough estimate of the extent of the difference between the two;

(3) of the respective upper and lower limits under the Patronage Cap-and-Collar Mechanism as set out in SSCA; the respective numbers of days on which the patronage touched the upper or the lower limit during the first 30 days of operation of XRL; for how long the patronage touching the upper or the lower limit has last before MTRCL and KCRC will bear the risk or share the return according to the specified ratio;

(4) as it is mentioned in the Paper that MTRCL will pay KCRC $10.7 billion, whether that amount is equivalent to the total “variable annual payments” to be paid by MTRCL to KCRC each year during the ten-year concession period, as calculated by the method set out in the Announcement; whether the method for arriving at that amount is based on the patronage forecasts in SSCA or the patronage forecasts in Annex 2 to the Paper; and

(5) as it is mentioned in the Paper that the total amount of Additional Concession Payments to be received by KCRC from MTRCL will be a net of about $2.7 billion, whether that amount is equivalent to 90 per cent of the Discounted Net Cashflow of the XRL project; whether the method for arriving at the amount of around $8 billion of “fixed annual payments” to be paid by KCRC to MTRCL is as follows: by deducting from the aforesaid $10.7 billion an amount equivalent to 90 per cent of the Discounted Net Cashflow of the XRL project?

Reply:

President,

     The Hong Kong Section of the Guangzhou-Shenzhen-Hong Kong Express Rail Link (XRL) officially came into operation on September 23, 2018 and has been operating smoothly in general. The MTR Corporation Limited (MTRCL) as its operator will keep improving various operating arrangements (such as ticketing, station facilities and services). Meanwhile, passengers are also getting used to using XRL as a cross-boundary transport mode.

     My reply to the various parts of the Hon Tanya Chan’s question is as follows:

(1) Since the commissioning of the West Kowloon Station, the Hong Kong Section of the XRL has a total patronage of 1 985 937, comprising 954 172 outbound passengers and 1 031 765 inbound passengers as at October 31, 2018. During this period, the average daily patronage for the Hong Kong Section of the XRL was 50 921 and the highest patronage for a day (October 5, 2018) was 80 020. Hong Kong passengers accounted for about 30 per cent of the total patronage while those from the Mainland and other nationalities about 70 per cent. We will compile statistics on the types of passengers and purposes of travel (such as business or tourism) for the XRL as well as the patronage of other cross-boundary transport modes and announce in due course.

     XRL is a brand new cross-boundary transport mode for Hong Kong. Passengers will need time to adapt to this new means of travelling. We cannot make a conclusive forecast on the long-term demand for XRL just on the basis of the patronage and the proportion of Hong Kong passengers for around the first six weeks after the commissioning of the Hong Kong Section of the XRL. We trust that patronage will increase progressively with increasing number of passengers enjoying the convenient services of XRL.

(2) The Government’s earlier forecast of the average daily patronage at the initial commissioning stage (i.e. 2018) and 2021 of the Hong Kong Section of the XRL would be 80 100 and 95 000 respectively. Based on an established transport model, we have input the latest figures and considered the latest planning data and development of Hong Kong and the Mainland to forecast the daily patronage for the XRL. Since the XRL is a brand new cross-boundary transport mode, for the purpose of ensuring the financial stability of the operation of Hong Kong Section of the XRL, the Government, the Kowloon-Canton Railway Corporation (KCRC) and the MTRCL has adopted a more prudent daily patronage forecast for the Hong Kong Section of the XRL in the business case (including the Patronage Cap-and-Collar Mechanism) for the Supplemental Service Concession Agreement (SSCA) As the MTRCL is operating on commercial principles, it would not be appropriate to disclose the commercially-sensitive financial projection method and data in the SSCA. The Government had explained the matters in detail when announcing the operating arrangements for the Hong Kong Section of the XRL on August 23, 2018.

(3) Since the commissioning of the Hong Kong Section of the XRL, the patronage has never touched the lower limit under the Patronage Cap-and-Collar Mechanism as set out in SSCA. In other words, the KCRC does not need to pay any compensation to MTRCL. The said mechanism is calculated on the basis of a calendar year and will not be triggered by the patronage fluctuation of individual days.

(4) and (5) Our overall target is that the Hong Kong Section of the XRL should be financially healthy and stable over the ten-year concession period, so that it does not require subsidises from KCRC on the one hand, and enable the MTRCL as a listed company to obtain reasonable commercial return, on the other. The net revenue (i.e. additional concession payments) is calculated entirely according to the established mechanism under the Operating Agreement, viz. calculated by taking 90 per cent of the Discounted Net Cashflow of each year of the new project (i.e. the Hong Kong Section of the XRL) during the concession period. The MTRCL will only retain the remaining 10 per cent. In this regard, it is estimated that the KCRC will receive about $10.7 billion of total concession payment (i.e. Variable Annual Payment) from the MTRCL over the ten-year period. This estimate is based on the patronage forecast as set out in SSCA. For accounting purpose, the KCRCL has to pay a fixed amount of about $8 billion to the MTRCL for meeting the expenses for the asset replacement of the Hong Kong Section of the XRL. According to the terms of SSCA, even if adopting the more prudent daily patronage forecast as set out in SSCA, the KCRC will still be able to receive a net revenue (i.e. additional concession payments) of $2.7 billion over the ten-year period. The Hong Kong Section of the XRL will also see positive overall operating profit (in terms of earnings before interest, taxes, depreciation and amortisation) and positive operating margin during the ten-year period. read more

     Following is a question by the Hon Ho Kai-ming and a written reply by the Secretary for Transport and Housing, Mr Frank Chan Fan, in the Legislative Council today (November 14):
      
Question
 
     Quite a number of households in public rental housing (PRH) estates have relayed that the lifts in the buildings in which they live have been in use for many years and are often out of service pending repairs.  On the other hand, the Electrical and Mechanical Services Department promulgated in 2011 the Guidelines for Modernising Existing Lifts (the Guidelines), introducing improvement proposals on enhancing the safety level of aged lifts and recommending the retrofitting of safety devices to aged lifts.  Regarding the repair and maintenance of lifts in PRH buildings, will the Government inform this Council:
 
(1) of the respective numbers of lifts (i) for which replacement works were carried out and (ii) to which safety devices were retrofitted according to the Guidelines, in each of the past five years (with a breakdown by name of estate);
 
(2) of the current number of aged lifts to which safety devices have yet to be retrofitted (with a breakdown by name of estate); whether it has plans to carry out the relevant works for such lifts; if so, of the anticipated completion date; and
 
(3) whether it will (i) specify a requirement on the minimum number of hours to be spent on carrying out routine repair and maintenance works for each lift by registered lift contractors (the contractors), (ii) require the contractors to regularly record the conditions of the core safety components of lifts, and (iii) engage independent third parties to review the quality of such repair and maintenance works; if so, of the details?
 
Reply
 
President,
 
     Having consulted the Electrical and Mechanical Services Department (EMSD), I set out the consolidated reply to various parts of the question raised by the Hon Ho Kai-ming as follows:
      
     According to the “Guidelines for Modernising Existing Lifts” promulgated by the EMSD, it is difficult to establish an unified minimum work time for maintenance works as the time for maintenance of each lift depends on the maintenance requirements by the lift manufacturer, its design, number of service floors, rated speed, rated load, and conditions of lift car, etc.  In 2014, the EMSD discussed with the trade about the work time for lifts/escalators maintenance.  The trade generally agreed that Registered Lift/Escalator Contractors should allow sufficient time for workers to carry out maintenance works properly.  In this regard, the EMSD also issued a notice to Registered Contractors in the same year to remind them that if they were to allocate maintenance works of more than six lifts/escalators for any worker to handle on one day, they should carefully consider the work allocation and ensure that the relevant works could be carried out safely and properly.
      
     According to the “Code of Practice for Lift Works and Escalator Works” (the Code) issued by the EMSD, Registered Lift Contractor, Registered Lift Engineer and Registered Lift Worker should record details of lift works, incident handling, emergency repairs, examinations and maintenance related matters on the logbook of the concerned lift on the day when the works are completed, including details of the replaced critical components of the lift.  The Responsible Person should also monitor the completion of works by the Registered Lift Contractor in accordance with the Code, the contractual requirements of both parties, etc., and countersign the logbook for confirmation.
      
     To enhance the safety of aged lifts and the protection of public safety, the EMSD requested the full implementation of the following two measures before February 1, 2019 through the promulgation of the new Code (2018 Edition) which was gazetted on August 10, 2018:
      
(1) Contractors shall conduct at least two special maintenance works each year for important protective components (including brakes, traction machines and landing doors) of aged lifts that have yet undergo modernisation works.  Contractors are also required to submit to the EMSD the scheduled date, time and inspection results of the special maintenance works via an online platform so as to enable the EMSD to strengthen the corresponding spot checks; and
      
(2) Contractors shall record maintenance works on logbooks with an improved format to list out the type and details of work involved in each round of maintenance works so as to facilitate more effective supervision over contractors’ maintenance works by the EMSD and the Responsible Persons for lifts.
      
     In addition, the Lifts and Escalators Ordinance (the Ordinance) stipulates that the Responsible Person for a lift must ensure that the lift and all its associated equipment or machinery are being kept in proper state of repair and in safe working order.  The Responsible Person shall engage a Registered Lift Contractor to undertake the maintenance works of the lift and ensure that periodic maintenance is carried out in respect of the lift at intervals not exceeding one month.  The Responsible Person shall also ensure that the lifts would be thoroughly examined by a Registered Lift Engineer at intervals not exceeding 12 months.  The EMSD adopts a risk-based approach and strengthens surveillance checks of those lifts with higher risk factors, such as with longer in-service years and frequent complaints or failures, so as to monitor the maintenance works and check against contraventions of the Ordinance.
      
     The EMSD also encourages Responsible Persons to appoint independent Registered Lift Engineers to review the maintenance work of their appointed contractors, and a “Sample Specifications for Engagement of Independent Registered Lift Engineer for Lift Maintenance Audit” is provided in the EMSD’s website for Responsible Persons’ reference.
      
     For the Hong Kong Housing Authority (HA), all lifts in HA’s public rental housing (PRH) estates, irrespective of their servicing ages, are maintained and repaired by Registered Lift Contractors in accordance with the Ordinance, relevant Codes of Practice and the requirements of the maintenance contracts.
      
     There are stringent requirements in HA’s maintenance contracts, for example, lift maintenance contractors have to submit a quarterly report and record the conditions of major safety devices in the lifts.  They also have to conduct routine maintenance on a weekly basis to ensure that the lifts are in safe working order.
      
     All repair and maintenance works for lifts are carried out not only under the monitoring by HA’s engineering staff, but are also regularly audited by the Lift Inspection Focus Team of the Independent Checking Unit under the Office of the Permanent Secretary for Transport and Housing (Housing).
      
     With a view to improving the service standards of the lifts, HA has been implementing the Lift Modernisation Programme which covers the installation of safety devices up to the latest standard.  In the past five years (i.e. from 2013/14 to 2017/18), HA launched the modernisation works of 309 lifts in PRH estates under the Programme.  Details are at Annex I.
      
     In coming five years, HA will continue to implement the Programme and schedule to tender for the modernisation of some 440 lifts in PRH estates in stages.  In 2018/19 and 2019/20, HA will launch lift modernisation works for 78 and 88 lifts respectively.  Details are at Annex II.
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     Following is a question by the Hon Shiu Ka-fai and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (November 14):
 
Question:
 
     Some hairy crab sellers have relayed to me that while hairy crabs are in season each year after the Mid-Autumn Festival, this year up to early this month, no hairy crabs (save for a small batch of hairy crabs in August) were issued with approval documents by the Mainland authorities for export to Hong Kong. This has greatly affected the sellers’ business. On the other hand, the Food and Environmental Hygiene Department (FEHD) found, during sampling checks conducted on hairy crabs in 2016, that two of the samples contained an excessive level of dioxins, and hence prosecuted two hairy crab sellers by summons. The magistrate acquitted the sellers and cited an expert’s advice that only if, within four months, an ordinary person consumed 47, or one with high health risk consumed 10, hairy crabs involved in the cases which had an excessive level of dioxins, would there be adverse effects on such person’s health, not to mention that ordinary people would not consume the aforesaid quantities of hairy crabs with an excessive level of dioxins. In this connection, will the Government inform this Council:
 
(1) as I have learnt that the Mainland authorities have been issuing approval documents for export of hairy crabs to other places, whether it has gained an understanding from the Mainland authorities as to why they have not issued this year approval documents for export of hairy crabs to Hong Kong; if so, of the details; if not, the reasons for that;
 
(2) whether it has maintained good communication and negotiated with the Mainland authorities with a view to resolving, as soon as possible, the issues concerning the supply of hairy crabs to Hong Kong; if so, of the details as well as the policy bureaux and government departments responsible for such work;
 
(3) given that the action level adopted by FEHD’s Centre for Food Safety for dioxins and dioxin-like polychlorinated biphenyls in hairy crabs stands at 6.5 picograms toxic equivalent per gram of the sample, whether it knows how this action level compares with those relevant levels adopted by the Mainland and other jurisdictions (set out in a table); whether there are differences between the levels adopted by those jurisdictions for the hairy crabs cultured locally and for those imported; and
 
(4) given the aforesaid expert advice, whether the Centre for Food Safety has studied relaxing the aforesaid action level; if so, of the outcome; if not, the reasons for that?
 
Reply:
 
President,
 
     The Public Health and Municipal Services Ordinance (Cap. 132) stipulates that all food for sale in Hong Kong must be fit for human consumption. Food safety is our prime concern in the surveillance and testing of imported food.
 
     Regardless of their places of origin, hairy crabs can be imported into Hong Kong provided that they meet Hong Kong’s food safety requirements and each consignment is accompanied with a health certificate issued by the relevant authorities of the exporting economies. The source of supply of hairy crabs to Hong Kong is essentially determined by the market.
 
     In the hairy crab season of 2016, the Centre for Food Safety (CFS) of the Food and Environmental Hygiene Department detected that the levels of dioxins and dioxin-like polychlorinated biphenyls (hereafter referred to as dioxins) of some hairy crab samples exceeded its action level. To maintain public confidence on the safety of hairy crabs available for sale in Hong Kong, CFS has implemented an arrangement since 2017 to hold up hairy crabs at import level and take samples for testing of dioxins. The importers concerned may make available the hairy crabs for sale in the market only after they are informed by CFS of satisfactory testing results. This hold-and-test arrangement is still in use by CFS.
 
     For the hairy crab season this year, the import of hairy crabs so far is as follows:
 
(a) in mid-August, a consignment of hairy crabs totalling about 100 kg imported from the Mainland and accompanied with a health certificate was released to the market after the test results on the samples were found satisfactory by CFS;
 
(b) since September, 13 consignments of hair crabs totalling about 3 100 kg imported from Japan and accompanied with health certificates were made available to the market for sale after the test results on the samples were found satisfactory by CFS; and
 
(c) since the end of October, eight consignments of hairy crabs from the Mainland totalling about 7 000 kg, which were imported from Korea and accompanied with health certificates, were made available to the market for sale after the test results on the samples were found satisfactory by CFS.
 
     Regarding the various parts of the question, our reply is as follows:
 
(1) and (2) The Mainland authorities monitor the quality of hairy crabs for supply to Hong Kong at source. They have their established approval procedures regarding the issuance of authorisation documents for the export.
 
   We understand that hairy crabs are seasonal fresh food. In this regard, the Food and Health Bureau (FHB) and CFS have been liaising closely with the relevant Mainland authorities on the import arrangements of hairy crabs from the Mainland into Hong Kong this year, with a view to striking a better balance between food safety protection and business facilitation. FHB and CFS have also been informing the trade from time to time of issues relating to the import and testing arrangements of hairy crabs this year. If there are any new arrangements, we will inform the trade immediately.
 
(3) Dioxins are highly toxic carcinogens. The Government has started testing the levels of dioxins in food since 1999 and in hairy crabs since 2014. Taking into account the regulatory arrangements of economies which had set standards on the levels of dioxins in crabs (the EU and Taiwan) and the local dietary habits on hairy crabs, CFS set an action level of 6.5 picograms (pg) toxic equivalent per gram of the food sample (wet weight) for dioxins in edible portion of hairy crabs in 2016. The standards of the EU and Taiwan are as below:
 

Economies	Per gram of crab sample (wet weight)	Total maximum level of dioxins and dioxin-like polychlorinated biphenyls (pg toxic equivalent)
The EU	Muscle meat from appendages	6.5
Taiwan	Whole edible portion

 
(4) Food is the main source of human intake of dioxins. Dioxins are fat-soluble, not easily broken down, accumulate in fatty tissues, and may accumulate in human bodies through the food chain.
 
     CFS has assessed the health risks of consuming hairy crabs containing dioxins. The results showed that the health risks vary depending on the background exposures to dioxins of individuals and the levels of dioxins of hairy crabs consumed. In any case, the higher the levels of dioxins of hairy crabs, the less the amount that can be consumed safely. Individuals with high background exposures to dioxins are more likely to have higher health risks than those with average background exposures if the same amount of hairy crabs containing the same levels of dioxins are consumed.
 
     CFS will continue to keep in view the latest development in the regulation of dioxins in food in other economies, the local dietary habits and other factors, and constantly review its regulatory arrangements for the levels of dioxins in hairy crabs, including the action level. read more

     Following is a question by the Hon Paul Tse and a written reply by the Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (November 14):

Question:

     A statistical report on breast cancer published by an organisation has pointed out that breast cancer is the most common cancer among women in Hong Kong. Hong Kong is one of the regions in Asia with high incidence of breast cancer, with an incidence of breast cancer of one in every 16 women, which is much higher than those of cervical cancer (which is one in every 128 women) and colorectal cancer (which is one in every 34 women). Besides, the number of cases of women diagnosed with breast cancer in Hong Kong increased by about three times in the past two decades. In 2015, 3 900 women were diagnosed with breast cancer and, among them, more than 900 had reached either the advanced stage or the terminal stage when they were diagnosed. The organisation has pointed out that with early treatment, the survival rates of breast cancer patients is as high as 90 per cent. While the governments of 34 countries and regions (including those in Europe, the United States and Canada) have long implemented breast cancer screening programmes, the Hong Kong Government has for a protracted period of time not implemented such a programme. In this connection, will the Government inform this Council:

(1) whether it has compiled statistics on the number of patients diagnosed with breast cancer in each of the past two years and, among them, of the number of those who had reached Stage III and Stage IV when they were diagnosed; if it has not, of the reasons for that;

(2) given that (i) the Government implemented the cervical cancer screening and colorectal cancer screening programmes in 2004 and 2016 respectively, but both cancers have a lower incidence than breast cancer, (ii) the results of a study conducted by the Singapore Government in 1996 reportedly revealed that population-based screening effectively lowered the occurrence of advanced breast cancer, and (iii) breast cancer screening programmes have long been implemented by the governments of 34 countries and regions worldwide, whether the Government has assessed if the following conclusion reached earlier by the Cancer Expert Working Group on Cancer Prevention and Screening is still valid: there is at present insufficient evidence to support the implementation of population-based breast cancer screening;

(3) as it has been reported that a computer algorithm failure lasting 10 years since 2009 on the part of the United Kingdom authorities has resulted in 450 000 women missing out the breast cancer screening opportunity, which may have caused the deaths of hundreds of women, whether it has estimated the annual number of Hong Kong women who (i) may die from breast cancer because they have missed out the opportunity for receiving timely treatments as a result of not receiving breast cancer screening services and, and (ii) can be identified as suffering from early breast cancer through screening services; and

(4) as the findings of a survey have revealed that, among the 802 female respondents, over half of them did not know that breast cancer is the most common cancer among women, over 70 per cent of them did not receive mammography on a regular basis, and nearly 80 per cent of those respondents who were aged above 40 were willing to receive free screening, whether the Government will, in the light of the relevant situation, consider afresh the introduction of the relevant services through the public-private partnership approach, or the provision of subsidies under the Community Care Fund for women to receive such services?

Reply:

President,

     The Government attaches great importance to cancer prevention and control. The Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) under the Government’s Cancer Coordinating Committee regularly reviews and discusses the latest scientific evidence, local and worldwide, with a view to making recommendations on cancer prevention and screening suitable for the local population. My reply to the various parts of the question raised by the Hon Paul Tse is as follows:

(1) The Hong Kong Cancer Registry (HKCaR) of the Hospital Authority oversees cancer surveillance and assists in compiling and analysing data on cancer cases in the local population to facilitate the planning of relevant medical services. According to the HKCaR’s statistics, there were 4 108 new cases of female breast cancer in Hong Kong in 2016. Among these cases, 659 and 345 were diagnosed at Stage III and Stage IV respectively.

     The HKCaR is collating the data for 2017 including cancer data from public and private hospitals, which involves a considerable amount of raw data. Generally speaking, the HKCaR needs to consolidate, screen and verify the data according to international standards before the number of new cases of different types of cancer each year can be released.

(2) As regards population-based mammography screening, after considering the emerging scientific evidence, the CEWG considers that it is still unclear whether population-based mammography screening does more good than harm to local asymptomatic women. Therefore, CEWG concludes that there is insufficient scientific evidence to recommend for or against population-based mammography screening for women at average risk in Hong Kong.

(3) and (4) In examining whether to introduce a population-based screening programme for a specific disease or cancer (including breast cancer), the Government shall make reference to the CEWG’s recommendations and carefully considers a number of factors, including the seriousness and prevalence of the disease locally, accuracy and safety of the screening tests for the local population, as well as effectiveness of the screening programme in reducing disease incidence and mortality. The Government shall also give due consideration to the actual circumstances such as the feasibility, equity and cost-effectiveness of the screening programme and public acceptance.

     Women at increased risk (such as carriers of certain deleterious gene mutations, those with a family history of breast or ovarian cancer, etc.) should seek doctors’ assessment and advice before deciding whether they should undergo breast cancer screening. The Department of Health provides woman health services at its three Woman Health Centres and ten Maternal and Child Health Centres for women aged 64 or below. The services include clinical breast examination and mammography for women who are identified as having high risk of developing breast cancer after medical assessment. Women identified with breast abnormalities after examination will be referred to specialist out-patient clinics for follow-up.

     As for asymptomatic women at average risk, the Government and the medical sector need to gather more research findings and data to explore whether it is appropriate to implement population-based breast cancer screening for this group of women in Hong Kong. In this regard, the Government has commissioned the University of Hong Kong to conduct a study on risk factors associated with breast cancer for local women so as to help formulate the future strategies for breast cancer screening in Hong Kong. The study is expected to be completed in the latter half of 2019. The aim of the study is to formulate a risk prediction model for breast cancer in Hong Kong using a case-control study approach under which a comparison is made between women with and without breast cancer. It also aims to find out the relations between risk factors (such as age, body mass index and other personal characteristics, physical activity, family history of breast cancer, history of benign breast disease, etc.) and breast cancer development. The Government will review and consider what type of screening is to be adopted for women of different risk profiles, having regard to the scientific evidence and outcome of the study.

     Some western countries and regions which have relatively high incidence of breast cancer have implemented population-based mammography screening programmes since the 1980s. However, studies found that there was only a slight drop or even no reduction in the mortality of breast cancer after implementation of such programmes. Some studies revealed that screening programmes have caused problems and harm such as over-diagnosis and over-treatment. As for countries and regions which have a predominantly Chinese or Asian population and have implemented population-based breast cancer screening programmes, detailed assessment data on the effectiveness (such as data on whether the programmes can effectively reduce the mortality of breast cancer among the female population, increase the long-term survival rate of such patients, etc.) and cost-effectiveness of the programmes have yet to be published by the governments concerned. Given the lack of justification from public health perspectives as supported by scientific evidence, the Government at present does not have plans to introduce a population-based mammography screening programme. Notwithstanding this, we will review the situation and formulate future strategies for breast cancer screening in the light of the findings of the aforementioned study on risk factors associated with breast cancer for local women.

     In fact, many risk factors for breast cancer are closely related to lifestyles, such as lack of physical activity, alcohol consumption, obesity after menopause, etc. The Government will enhance education and publicity on breast health. Through mass media and collaboration with community partners and service providers, the Government will actively promote the adoption of healthy lifestyles (e.g. avoiding alcohol consumption, having a balanced diet, doing regular exercise, maintaining healthy body weight and waist circumference, prolonging breastfeeding duration, etc.) as the major preventive strategy. It will also promote the awareness of breast health among women for early detection of breast abnormalities and immediate medical attention. read more