Seanad debates

Tuesday, 15 July 2014

Adjournment Matters

Cancer Screening Programmes

8:30 pm

Photo of Pat O'NeillPat O'Neill (Fine Gael)
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I welcome the new Minister for Health, Deputy Leo Varadkar, and wish him all the best in his new role.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I will need it.

Photo of Pat O'NeillPat O'Neill (Fine Gael)
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As his understudy in this House in the area of transport, I appreciate the Minister's grasp of relevant issues. I know he will do a good job in his new position.

Photo of Marie MoloneyMarie Moloney (Labour)
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I welcome the Minister and congratulate him on taking up his new portfolio. Many are inclined to forget that he is a qualified GP. However, I do not do so because he graduated on the same day as my son. I know he will have a good grasp of the health portfolio.

Many years ago I was actively involved in a campaign to have the BreastCheck service rolled out to the southern region, particularly counties Cork and Kerry. I spent many a wet Saturday on the streets of towns and villages in County Kerry getting both men and women to sign petitions. They were very eager to sign because they were anxious to have the BreastCheck service extended to the region. As the Minister knows, it was eventually rolled out to it. Many of my friends are indebted to BreastCheck as a result of their breast cancer being detected early. Some of them have informed me that their tumours were only about the size of the head of a pin when detected, which meant that they were only obliged to undergo lumpectomies because the cancer had not spread to the lymph glands. As a result, they did not require chemotherapy and all have recovered. I hope hey will all remain in remission.

The Irish Cancer Society has indicated that for every 500 women screened, at least one life will be saved. I argue that the figure is even higher than this, particularly in view of the number of women I meet in whom breast cancer has been detected by BreastCheck. However, the Irish Cancer Society is the expert in this area and the figure to which I refer is the one it has supplied. One woman in ten will contract cancer during her lifetime. As the Minister is well aware, BreastCheck screens women in the 50 to 64 year age group every two years. The programme for Government contains a commitment to extend the BreastCheck service to women aged 65 to 69 years. I ask the Minister to not allow this to be perceived as a broken promise, as a failure to extend the service will cost us more in the long term. The sooner breast cancer can be detected, the less treatment women will require. If it is not detected early, the women involved will need long-term care plans which can be quite costly.

I ask that the extension of the BreastCheck service to women aged between 65 and 69 years be approved without further delay. As stated, the Minister should not allow this to become a broken promise and oblige us to organise another campaign. As we promised the extension, let us deliver it.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I thank the Senator for her kind words and welcome the opportunity to speak about the proposed extension of the BreastCheck programme to include women aged 65 to 69 years. BreastCheck, the national breast screening programme, offers free mammograms every two years to women aged 50 to 64 years. It is now in its 15th year of screening and has provided almost 1 million mammograms for just over 400,000 women. Approximately 6,350 cancers have been detected through the service. The programme for Government contains a commitment to extend the BreastCheck programme to 65 to 69 year old women in line with EU guidelines. I can confirm that I intend to extend the upper age range to include women in the 65 to 69 year age cohort as soon as the requisite resources can be procured.

A priority of BreastCheck is to maximise the national uptake in the 50 to 64 year age group. As outlined in the recently published BreastCheck report for the period 2012 to 2013, 71.4% of eligible women invited for screening accepted their invitations. As the target in this regard is 70%, it has been exceeded. However, acceptance rates among those invited for the first time have fallen to 66.4%, which is a source of some concern. In the light of these figures, I welcome the current BreastCheck advertising campaign which aims to boost uptake rates and urges all women to take the time to do something very important for themselves by availing of the invitation to have mammograms. At a minimum, this will give some peace of mind, but it might also just be crucial in identifying cancers at an early and more easily treatable stage.

The HSE's national screening service operates three other population-based screening programmes, in addition to BreastCheck. These are CervicalCheck, the national cervical screening programme which provides free smear tests for women between the ages of 25 and 60 years; BowelScreen, the national bowel screening programme which commenced nationwide in late 2012 for men and women aged 60 to 69 years and for which an additional €2 million was provided for its continued development in the HSE's national service plan for 2014; and Diabetic RetinaScreen which commenced in February 2013 and will be offered to people aged 12 years and over with diagnosed diabetes who are registered with the programme. An additional €4.5 million has been allocated for the continued implementation of Diabetic RetinaScreen in the HSE's national service plan for 2014.

Breast screening is one element of the comprehensive cancer care programme. As part of its work across the full range of cancers, the HSE's national cancer control programme provides symptomatic breast clinics at each of the eight cancer centres and a further satellite clinic in Letterkenny. Breast cancer survival rates in Ireland have improved significantly in recent years owing to a combined approach of screening, symptomatic detection and improved treatment.

The five-year survival rate for breast cancer is now estimated at 84.9% for people diagnosed between 2005 and 2009. This is a most encouraging figure and shows a significant improvement from the figure of 75.1% for those diagnosed between 1994 and 1999. I welcome the progress being made, not just to the benefit of the people directly concerned but also to their families, friends and wider communities.

8:40 pm

Photo of Marie MoloneyMarie Moloney (Labour)
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I thank the Minister for his reply. Can he give an indication as to when we should expect the extension of the scheme to this particular age group? I very much welcome the advances in the cancer screening regime, which is having a significant impact in terms of earlier detections. The diabetic retinal screening programme that was launched last year is another welcome development. I acknowledge the difficult reality of limited resources, but the bottom line is that these schemes save money in the long run. Will the extension of BreastCheck be rolled out this year, as promised, or does the Minister have expectations for next year? If not, is it likely to happen at all in the lifetime of this Government? I am sure the Minister will refer to budgets in his reply, but I urge him to examine how the funding can be found for this very important programme.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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Nobody disputes the science in terms of the benefits of extending BreastCheck to women aged 65 to 69. However, as the Senator acknowledged, budgetary considerations must figure. Unfortunately, as these things always are, it a question of money. While there may be long-term savings deriving from an extension of the screening programme, the money needed to implement that extension must be found upfront. To take the funding from existing resources would most likely require its diversion from patients who are currently diagnosed. Taking resources away from those already receiving treatment for an illness in order to extend screening to those who might have an illness is not something I could stand over.

Having said that, we have costed the extension of the scheme, and the figure for 2015, at some €200,000, is actually not that high. However, because we would need to expand the units, build new centres and so on, that cost would rise in 2016 to almost €6 million, which is a much more significant figure. It is an issue of which I am very aware and I am pleased the Senator has brought it to the forefront of my attention in my first week in office. I absolutely see the logic behind her proposal for an extension and it is something I absolutely want to implement. I will do so if the resources are available, but I cannot do it at the expense of treating people who are already diagnosed. I am sure Senators will understand why that is the case.