Professor Fidelma Flanagan:

The impact of a screening programme, whether people attend or do not attend, is far-reaching. Not only does it have an impact on women who attend, because of the opportunity to pick up early diagnoses, but the evidence is very clear that in a society where there is screening, it raises all boats. Even for women who attend for screening only intermittently, it is better than not attending at all. The aim of screening is to detect early breast cancer before it becomes symptomatic. It is an opportunity that always should be availed of and encouraged. Much of the work we do is to ensure that even if women have not attended for their first appointment, the opportunity is always there on subsequent appointments. Screening is a journey, involving not just one mammogram but a series of mammograms. Even if women have not come for one appointment, we encourage them to come for the next one. We want them to contact us to see whether they are on the population register and getting their invitations. They should not be afraid to make a telephone call if they have missed their appointment because we can easily accommodate them if they are on our system.

Reference was made to one of the major efficiencies we have implemented to maximise appointments. In the past, we used to offer people a second appointment if they did not turn up. We found, however, that take-up was less than 30%. We now maximise first appointments and invite those women to call us in order that we can make an appointment knowing they will turn up, rather than offering an appointment while expecting that they will not turn up. That has been a really positive development.

We would like to think we will be back to full screening after we get through this round, but it will take three years to get this round done. There are confounding factors. One of the challenges we have at the moment is the worldwide deficit of radiologists, specifically breast radiologists. That is probably going to be one of the greatest difficulties we have into the future in delivering these programmes. If everything stays as it is, we have a good chance of getting back to our two-yearly programme, but we need to address some of the challenges we anticipate as we move ahead.