Ms Fiona Murphy:

Different parts of Sweden screen at different ages. Very few European countries start screening before the age of 50. A few countries go to 45. I am aware that Iceland starts screening at the age of 40, but they have in fact gone back to their Parliament to ask to increase the age back to 50 again because they found that screening from the age of 40 was not effective and that people were not turning up for screening. A screening service would need enough people to be coming.

I go back to Professor Flanagan's answer from earlier, that the incidence of screening from 40 to 50 is lower. Incidence really starts to increase at the age of 50. We are aware and looking very closely at whether incidence at the age of 45 would merit a screening programme. I do not believe there are many countries that would suggest the age of 40. The European Union guidelines currently say that everybody should start screening at 50, and that we should consider whether we should do that from 45. We mentioned earlier that those considerations are being looked at by the National Screening Advisory Committee, which advises the Government on the ages of screening, and will then tell us what to do and we would implement it.

On how much it would cost, we have not done that assessment yet. We would need to do that as part of the evidence review. It is very important to remember what Professor Flanagan said earlier, that the main barrier to screening under the age of 50 is the lower incidence. We would be at risk of doing more harm than good. While the test we currently use, which is a mammogram, is effective at 50, it is less effective at lower ages. We would also need to think about what test we could use. There are a lot of considerations to look into once one starts going below the menopausal age of approximately 50.