Ms Fiona Murphy:

Yes. For the people referred directly from their GP because they have a lump or any other symptom, the cancer detection rate is approximately 100 per 1,000. That compares with seven per 1,000 from our screening. As we are screening a huge population of women, amounting to half a million every two years, we will detect fewer cancers. If we go down an age group, we will detect even fewer. That is one of the problems with reducing age.

The second problem is that the mammogram itself, which is the only test we currently have that is internationally proven to be useful in detecting cancer in otherwise healthy people, becomes less effective the younger the subject of the screening. That is do with the tissue in the breast, which becomes harder to read as we go down in age.

Having said all of that, there is great interest in reducing the age of breast screening recipients. We have applied to the national screening advisory committee, which Dr. Henry mentioned earlier, to ask it to consider the matter. The issue is on the committee's books. It will ask HIQA to do what it calls a health technology assessment to see whether it is worth doing this. Once that is done, it will be up to us to put any recommended changes in place. There needs to be a long-term plan for any such change. It is not just about screening. As has been mentioned a couple of times, once we are screening, we need to make sure we have follow-up services available. At the moment, we invite back approximately 4%, or one in 25, of the people who have a mammogram for further tests. We need to do that in a timely fashion. For the people who go on to have cancer treatment, we must ensure there is sufficient surgery capacity and so on. Reducing the age of eligibility for screening will require a bigger infrastructure plan.

This might be counted as an answer to a further question but there are other cancer screening programmes where the benefit of reducing the age might be greater than for doing it with breast screening. Part of the function of the national screening advisory committee is to tell us which programme will give us the most value. It is then up to us to implement changes.