Helen McEntee (Meath East, Fine Gael)
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I thank the Minister for Health for taking this issue and my colleague, Deputy O'Donnell, for raising it. BreastCheck, which is the national free screening programme for breast cancer, currently extends to women aged between 50 and 64 years of age. It is a fantastic programme.

The only figures available to me are from 2012 but I assume that the figures for last year and this year are similar. During 2012, some 183,632 women were invited to partake in a breast screening procedure and 71.4% of eligible women accepted the invitation. This was in excess of the 70% figure set as a target for the programme. The lives of thousands of women have been saved by BreastCheck.

Unfortunately, breast cancer is the most common cancer among women in Ireland. A woman has a one in ten chance of developing breast cancer but early detection is key to dealing with it. This is why women from the age of 50 years are eligible for the programme. I recognise that we must operate under budgetary constraints and that a bracket has to be put on eligibility but given that one in ten incidents of breast cancer occur among women aged between 65 and 69 years, we need to reconsider the age limits. Death rates from breast cancer are second highest in the 60 to 69 years age group. The programme for Government promised to extend the free screening service to women aged between 65 and 69 years. I ask the Minister to ensure this is done at the earliest opportunity.

Kieran O'Donnell (Limerick City, Fine Gael)
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I thank the Minister for facilitating us as we raise this critical issue and I also thank my colleague, Deputy McEntee, for contributing. I feel strongly about the issue. BreastCheck should be extended to people aged between 65 and 69. These people could be our wife, a mother, a sister, a daughter, a relative or a female friend. The current BreastCheck scheme, which includes people up until the age of 64, works very well, and it is in the programme for Government that it would be extended to people aged between 65 and 69. Currently, women aged between 50 and 64 are invited for a free mammogram every two years but as my colleague mentioned, there is one in ten incidence of breast cancer in women aged between 65 and 69. I have already raised the matter with the Minister and I have written to the chief executive of the HSE, Mr. Tony O'Brien, about the matter. As Deputy McEntee stated, there is a commitment in the programme for Government to extend the initiative. HIQA made a similar recommendation in 2010.

Screening saves lives by catching cancer early, and for every 500 women screened, will ensure that one life will be saved. Women between 60 and 69 have the second-highest incidence of breast cancer and the second-highest risk of dying from the disease. Nevertheless, the older half of this age group is currently ineligible for screening under BreastCheck. Almost 2,800 women are diagnosed annually with breast cancer, and it is the second-highest cause of cancer deaths in women after lung cancer. In 2012, 675 women died from breast cancer.

A plan to roll out the free breast cancer screening scheme to women aged between 65 and 69 should be included in the HSE national service plan for 2015, which will be published in the autumn. We must ensure these women can have continued care after they reach 65.

James Reilly (Dublin North, Fine Gael)
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I thank Deputies McEntee and O'Donnell for raising this important issue and I welcome the opportunity to speak to it. BreastCheck, the national breast screening programme, currently offers a mammogram every two years to women aged 50 to 64. This service is provided free of charge by the HSE through its national screening services, and BreastCheck is now in its 15th year of screening, having provided 964,000 mammograms to 409,000 women. Approximately 6,350 cancers have been detected through this programme. Deputies are well aware of the budgetary restraints under which we must operate but I can confirm it is my intention to extend the upper age range for BreastCheck to include the 65-69 age cohort as soon as possible in line with available resources.

A priority of the BreastCheck programme is to maximise national uptake in the 50-64 age cohort. As outlined in the recently published 2012 and 2013 BreastCheck report, 71.4% of eligible women invited for screening accepted their invitation, which is in excess of the programme target of 70%. However, acceptance rates for those invited for the first time have fallen to 66.4% and this is a matter of some concern. In the light of these figures I welcome the current BreastCheck advertising campaign, which aims to boost uptake rates. I realise we all lead busy lives these days but I call on women to take the time to do something very important for themselves by availing of invitations to have mammograms. At a minimum this will give some peace of mind but it might just be crucial in identifying cancers at an early and more easily treatable stage.

Breast screening is one element of our comprehensive cancer control programme and as part of its work across the full range of cancers, the HSE's national cancer control programme provides symptomatic breast clinics in each of the eight cancer centres, with a further satellite clinic in Letterkenny. Breast cancer survival in Ireland has improved significantly in recent years due to a combined approach of screening, symptomatic detection and improved treatment. Five-year survival for breast cancer is now estimated at almost 85% for people diagnosed between 2005 and 2009. This is a most encouraging figure, indicating a significant improvement from 75.1% for people diagnosed between 1994 and 1999. I very much welcome the progress being made, not just to the benefit of the people directly concerned but also to their families, loved ones and wider communities.

BreastCheck is aimed at the cohorts most at risk but breast cancer services are available for all women. Those of any age who have concerns about breast cancer should seek the advice of their GP, who will, if appropriate, refer them to the symptomatic breast services in a designated specialist cancer centre. Screening should never be taken as a substitute for attending a doctor if there is a health concern related to breast changes or other issues.

Helen McEntee (Meath East, Fine Gael)
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I thank the Minister for his response. After 15 years there have been over 950,000 mammograms, which is great news. As Deputy O'Donnell noted, these women are somebody's mother, sister, aunt or grandmother. It is more difficult for people to recover from an illness later in life and deaths from breast cancer are the second highest rate in the 60-69 age group. We are missing four years of that cohort in the current BreastCheck programme.

I welcome the Minister's statement that he is keen to implement this as soon as possible. I urge that it be done this year if possible and it would be great if the Minister could give us a timeframe. With all types of cancer and illnesses that can be screened, people should be vigilant, as the Minister indicated. This programme cannot cater for everybody as we are under budgetary constraints. People should be vigilant as well as availing of the screening if required. Will the Minister keep us abreast - to use an apt word - of what is happening?

Kieran O'Donnell (Limerick City, Fine Gael)
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I thank the Minister for his response. BreastCheck was rolled out in Limerick in recent years and I raised the matter in the Dáil at the time. I have seen its positive impact. There are benefits for women aged between 50 and 64 and it improves survival rates. For every 500 women screened, one life is saved, and the older cohort of those aged between 65 and 69 has a breast cancer incidence of one in ten, so this should be given immediate priority in line with the commitment given in the programme for Government. Will the Minister commit to achieving this in the lifetime of this Government? The programme has made an enormous difference to the women of Limerick and the mid-west region, as well as to their families.

James Reilly (Dublin North, Fine Gael)
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I reiterate our commitment in the programme for Government to do this, although Deputies will be aware of the serious budgetary reductions which have occurred over the past years to facilitate our getting this country back on its feet. The Government has done that very successfully to date. There are great challenges in this year's budget with competing priorities and public health, prevention, early detection and screening are very important issues. When we considered the budgetary constraints, we had very difficult choices to make. For example, if we did not invest in diabetic retinopathy screening, citizens would go blind, never to regain their sight. If we did not roll out bowel screening for colorectal cancer, people would again be at risk of presenting late with poor outcomes. There are 12 clinical nurse specialists who have commenced training to carry out colonoscopies through the screening programme, with an additional €2 million for the continued roll-out of bowel screening in the HSE national service plan for 2014. That will facilitate retention of the three-year first round interval for screening in the 60-69 age cohort. This is a serious cancer affecting both men and women.

On top of that we had to consider organ transplants, as we have more living donors prepared to make that most generous of gifts, particularly with kidneys.

Last year was a very successful year when there were 294 successful transplants, up from 239, which is a massive increase. We wish to see this continue and encourage people to be aware of it. There are competing areas for screening and cancer detection, in addition to our initiatives on the human papilloma virus, HPV, vaccine to protect young girls from developing cervical cancer later in life and the continued cervical screening. It is a Government commitment, one that I am very pleased to commit to as soon as possible and certainly within the lifetime of the Government.