Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I am pleased to mark breast cancer awareness month and to discuss this important topic. At the outset, I wish to acknowledge the great commitment of those working in cancer services in hospitals, screening services, community services and the charitable and voluntary sectors. This has enabled the continued provision of quality care to individuals during the Covid-19 pandemic and following the cyberattack in May.

Cancer prevention is a cornerstone of the National Cancer Strategy 2017-2026. Prevention aims to improve the overall health of our population and offers the most cost-effective, long-term approach for cancer control. The proportion of the incidence of cancer attributable to modifiable lifestyles and environmental factors is estimated to be in the 30% to 40% range. Modifiable lifestyles or environmental risks exist for many cancers. Of these, smoking is the most important. Others include excess body weight, physical inactivity, alcohol consumption and sun exposure.

Prevention measures are promoted by the Government as part of the overall health and well-being initiatives under the Healthy Ireland programme. Initiatives such as breast cancer awareness month bring a renewed and targeted emphasis on prevention. It presents opportunities for us all to promote breast awareness and spurs us on in our efforts to promote the message across the population that people can impact significantly on their own risk of developing cancer.

Breast cancer is the most commonly diagnosed invasive cancer among women in Ireland. It affects approximately 3,500 women every year as well as a very small number of men. Breast cancer is the second leading cause of cancer deaths among women in Ireland. However, survival rates are improving significantly. The latest breast cancer statistics from the National Cancer Registry show that five-year net survival for breast cancer patients improved from an average of 70% for a diagnosis in the period 1994 to 1999, to 85% in 2011 to 2015. This represents an approximate halving of the five-year mortality risk over that time. As these figures predate the introduction of the current national cancer strategy and the improvements made in recent years, it is expected that the next set of figures will show a further substantial improvement.

The vision of Ireland's national cancer strategy is that we will strive together to prevent cancer and work to improve the treatment, health and well-being, and experiences and outcomes of those living with and beyond cancer. It is about preventing cancer across our population, diagnosing it early, providing optimal care to people and maximising their quality of life.

Each year, approximately one third of all breast cancers diagnosed in Ireland are detected through BreastCheck. I am happy to report that routine screening appointments in BreastCheck are returning to normal despite the impact of Covid-19 and the recent cyberattack. Approximately 86,000 women were screened between January and September of this year. Unfortunately, due to nearly a year of screening time being lost because of the impact of Covid-19, it will take longer to get through the current screening round, that is, approximately three years when it normally takes two. However, this is still within international norms, as Ireland screens more frequently than many other countries. People who have been waiting the longest will generally be invited first. The National Screening Service is working hard to return breast screening to two-year screening and to doing so in a safe manner. It should be noted that, even when screening was paused, the programme continued to operate follow-up clinics, providing support to the symptomatic breast cancer services.

Additional funding of €10 million was provided for cancer screening in 2021. This is helping to increase capacity. This investment includes two new mobile screening units for BreastCheck, located in Donegal and Dublin, with a third mobile unit coming on stream in 2022. In line with commitments in the programme for Government, BreastCheck is currently implementing an age extension project that will see all women between 50 and 69 years of age being invited for routine breast screening. As with all of our national screening services, BreastCheck delivers its services in line with international criteria for population-based screening programmes that are kept under constant review.

As part of breast cancer awareness month, the National Screening Service and the HSE have launched an extensive national media campaign to highlight key details about symptom awareness, breast cancer prevention and screening during Covid-19. BreastCheck provides a great deal of information on its website, breastcheck.ie. This includes educational materials to encourage people to be aware of general breast health and information on the common symptoms for which they should seek medical advice.

All individuals are encouraged to attend for their BreastCheck appointments when they are called. Sometimes, people may be a little apprehensive or put it off for whatever reason, but it is important that they take up their appointments when they are offered. Early intervention is key.

BreastCheck has launched a campaign that aims to inform the public about any delay in appointments and to highlight the Covid-19 protective measures that are in place at screening locations. Before an appointment, a text message from BreastCheck is sent to confirm the appointment details. In this way, someone can rearrange an appointment if necessary and BreastCheck can offer the initial appointment to another person in the community.

Diagnosing cancer at its earliest possible stage is a critical first step in achieving higher survival rates, reducing treatment severity and improving patients' quality of life.

Patients who recognise suspicious symptoms and seek early medical intervention are generally more likely to have less advanced disease, less severe treatment and better outcomes. When cancers are diagnosed at stages 1 and 2, longer-term survival prospects are considerably better than for patients diagnosed at stages 3 and 4 of the disease. The five-year survival rate is 94% for people diagnosed with stage 1 disease and 19% for people diagnosed at stage 4.

Each of the eight designated cancer centres in the State has a symptomatic breast disease clinic, with a ninth clinic operating in Letterkenny University Hospital as a satellite of the service in University Hospital Galway. Approximately 42,000 new patients attend these clinics every year, having been referred by their GP. Between January and September this year, GP e-referrals for breast cancer were at 130% of the 2019, pre-Covid, rate.

The national cancer control programme continues to monitor closely trends in numbers coming forward to diagnostic services and the level of attendances for appointments for treatment, with a particular focus on urgent cases. The total number of new patients seen across symptomatic breast disease clinics between January and August 2021 was 98% of the figure for the corresponding period in 2019. Patients are triaged as urgent and non-urgent. Attendances at urgent symptomatic breast disease clinics from January to August 2021 were at 115% of 2019 levels, while attendances at non-urgent clinics were at 82% of 2019 levels. Furthermore, the total number of new cancers diagnosed in symptomatic breast disease clinics from January to August 2021 was 104.6% of figure for the corresponding period in 2019. All the statistics, as we can see, are going in one direction.

The national cancer control programme is currently developing a model of care for hereditary cancer, covering the identification and assessment of those with possible hereditary cancer risk, referral for counselling and testing when indicated, and co-ordinated surveillance when required. Increased staffing has been provided to the hereditary cancer service in St. James's Hospital, including a consultant in cancer genetics. In November last year, the hospital commenced a trial of a remote genetics testing provider, with the aim of improving turnaround times for testing during the Covid-19 period.

As previously indicated, breast cancer has very good survival rates. In fact, people with a diagnosis of breast cancer account for almost a quarter of all those living with and beyond cancer in Ireland. An extra €1.91 million is being used this year to continue the development of survivorship services, including psycho-oncology services, to improve the quality of life of those living with and beyond cancer. An additional €20 million was allocated for the continued implementation of the national cancer strategy this year, with €1.8 million allocated specifically for breast cancer services. This funding will drive improvements across all stages of the cancer continuum. In addition, there is funding of €12 million for the restoration of cancer services to 95% of 2019, pre-Covid, levels. This funding is being used to support hospitals in addressing backlogs, extending clinic times, providing additional clinics, increasing diagnostic capacity and providing locum and temporary support. I am delighted that the commitment of the Government to the implementation of the national cancer strategy is further emphasised by the allocation of an additional €20 million in budget 2022.

I take this opportunity, in breast cancer awareness month, to encourage people to attend for their BreastCheck appointments. If anybody, of any age, has concerns about cancer, I urge them to go to their GP, who will arrange appropriate follow-up care. As somebody who was called for a BreastCheck appointment a couple of years ago when I turned 50, I was apprehensive going for my first scan. We are all conscious of undressing in front of healthcare staff, but I was met by a lovely nurse. It is very important to go for the scan and it is such a relief when you get the results. Of course, some people do not get the result they want but, fortunately, early intervention is key. We all have friends and relatives who have had results that were not as good as they should have been but who have been able to get the treatment they need. I encourage everyone to go to screening appointments. I know all my colleagues in the House will encourage anyone who receives a BreastCheck appointment to go and have the check done. It only takes a few minutes and people will be glad when they have it over and done with.

The message I really want to give today is that our cancer diagnostic and treatment services are open and our healthcare staff will provide people with the care they need. I give way to my colleague, Deputy Murnane O'Connor, for the few minutes remaining in this slot.

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