Dr. Colm Henry:

I thank Deputy Butler. Screening involves bringing large numbers of healthy people into a healthcare setting to have a test done to see whether they may have had some changes, whether to the breast, colon or cervix, that may lead to precancerous or cancerous changes. On 27 March, we had a directive from NPHET to stop all non-essential services in this country. Across the world - in the Netherlands, the United Kingdom, Australia and New Zealand - we see that screening services have been stopped because of the risk of bringing healthy people into a congregated setting and thereby running the risk of an outbreak.

In normal times, any screening programme has both benefits and risks. Currently, bringing people into a congregated setting, whether it is a van for breast screening or a waiting room, is something that we cannot do. We cannot go back to business as usual. We have to consider everything. For example, in the case of breast screening, a van could normally accommodate between 40 and 50 cases a day, but this number could certainly not be done based on Covid principles. With good prevention and control principles, one could not do more than ten cases per day. The same applies to the waiting room. A mammogram requires close contact between a radiographer and a patient and will require a new way of working. Our screening programmes are focusing on symptomatic patients, as are other programmes internationally. To give an example, in the case of suspected breast cancer this would include a new symptom that might suggest cancer. We are supporting the symptomatic services in their endeavours to get back up and running in a Covid environment.

As to when we will restore screening services to the way we knew them, it is far too early to say, not just for this country but also internationally. This is because the principle of screening involves large numbers of people being available for testing.