Colm Burke (Cork North Central, Fine Gael)
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I ask the Minister of State, Deputy Rabbitte, if consideration can be given to the introduction of additional nationwide organised screening programmes for two of the four major cancers in Ireland, namely, prostate cancer and lung cancer, taking into account that the national screening programmes for breast cancer, cervical cancer and colorectal cancer have led to the early detection of cases in recent decades, and if he will make a statement on the matter.

The screening programmes, BreastCheck, CervicalCheck and BowelCheck, have been successful despite all of the criticism of them. It is important we recognise the people who have been at the forefront in pushing those programmes forward and those working on the front line. Looking at cancer diagnoses, prostrate cancer accounts for 16% of all cancer diagnoses in Ireland, while across the European Union it is 13%. Lung cancer accounts for 11% of diagnoses here and 12% of diagnoses across the European Union. Between 1995 and 2019, the number of cancer cases increased by more than 100%. If the increase in population is taken into account, the crude rate of increase in cancer cases is 48%, with a 52% increase among men and a 43% increase among women. Cancer mortality in Ireland also increased from 7,500 deaths in 1995 to 9,300 deaths in 2018. The reason is that people are living longer and therefore the rate of cancer in older people is also increasing. With people living longer, more cases of cancer will be identified, which is the reason for the increase in the number of people who have died of cancer.

It is predicted that cancer rates will increase from 27,000 in 2020 to 42,000 in 2040. We need to put in place mechanisms to identify cancers at a very early stage. One issue relates to prostate cancer and lung cancer. The National Screening Advisory Committee, NSAC, has received 53 submissions over the past 12 months and I understand it will announce and publish details of these submissions and the way forward. We now need to give serious consideration to this matter and be proactive. If we are not doing screening programmes in other areas, we need to identify what the symptoms are because many people end up taking action too late. Dealing with cancers that are far advanced then becomes a difficult challenge for the people caring for these patients. We need major public information campaigns for each of the cancers and the symptoms. When I was reading documentation before raising this matter, issues were identified to me that I was not aware of. I ask the Minister of State to give serious consideration to this proposal.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank Deputy Colm Burke for raising this matter, which I am taking on behalf of the Minister for Health, Deputy Stephen Donnelly. The Minister is committed to supporting our national population-based screening programmes. As we all know, screening saves lives and it is important that decisions on the introduction of new screening programmes are made in line with international best practices. As the Deputy may know, decisions about the introduction of new population-based screening programmes in Ireland are made on the advice of the National Screening Advisory Committee. This independent expert committee makes recommendations to the Minister and the Department on population screening in Ireland. As may be appreciated, the assessment of the evidence for making changes to screening programmes is a thorough process done in line with international accepted criteria and with scientific rigour. In addition to the scientific and technological information required to make evidence-based decisions, there are ethical, legal and societal issues which arise when planning enduring population-based programmes of this nature.

The NSAC works closely with the HSE, HIQA, clinicians and patient advocates in its approach to the consideration of expansion of population-based screening in Ireland. Its first annual call in 2021 for proposals for new screening programmes or changes to our existing programmes received a significant response. As the Deputy correctly stated, a total of 53 submissions were received, including on lung cancer and prostate cancer.

Submissions were received from various sources, including members of the public and patient advocates, and these underwent consideration by the committee at its scheduled meeting during 2022. The NSAC intends to publish its full work programme shortly.

As the Deputy may be aware, under Europe's Beating Cancer Plan, a proposal for an updated Council recommendation was adopted by the Commission in September 2022. The final recommendation is expected to be formally approved by the Council of the European Union in December 2022 and published thereafter. The NSAC will consider the recommendation and advise the Minister and the Department of Health on the evidence as it applies to Ireland.

As the Deputy noted, our current programmes have led to the early detection of cancers. The latest cancer trends report, published recently by the National Cancer Registry Ireland, focuses on cancers that are currently screened for. It reports on the incidence, mortality, stage and survival of patients diagnosed with female breast cancer, cervical cancer and colorectal cancer. The report shows the positive impacts of our three cancer screening programmes, namely, BowelScreen, BreastCheck and CervicalCheck, noting that they are effective, that they are detecting cancers earlier and that they are saving lives. The report shows that cancer cases detected through screening were, on average, found at a substantially earlier stage than other cases diagnosed at the same ages. More important, survival has improved for all three cancers, with the greatest improvements seen in the age groups targeted by the national screening programmes.

In light of all this, I trust the public can be assured of the ongoing commitment of both the Minister and me to the further expansion of population-based screening in Ireland, along with the awareness campaigns the Deputy highlighted.

Colm Burke (Cork North Central, Fine Gael)
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I very much look forward to the European Commission publishing its report and the recommendations in that regard. It is important we lead out in respect of those recommendations. I accept there is a cost factor and also an issue with recruiting people to deal with any changes that are brought about, but if we have a screening programme, we will save a great deal of money in the long term. The Minister of State mentioned the three screening programmes that are in operation, and it is important we talk positively about them. There has been much adverse coverage of the way some issues have been managed, but we are getting good results and identifying issues at an earlier stage. The public information aspect is very important, and we should focus in all areas of cancer on the essential signs and the reasons people need to go for checks. I ask that that be taken on board seriously by the Department.

I look forward to the report of the advisory council with a view to going forward with new screening programmes, not least in respect of lung and prostate cancer.

Anne Rabbitte (Galway East, Fianna Fail)
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I reiterate that the NSAC will consider the final European Council recommendations on cancer screening and advise the Minister and the Department of Health on the evidence as it applies to Ireland. The NSAC is committed to ensuring the expansion of population-based screening in Ireland in a safe, ethical, robust and evidence-based manner. The introduction of a new population-based screening programme, therefore, can be a lengthy and complex process and can be possible only after a full evidential assessment has been completed against internationally accepted criteria and with scientific rigour. These programmes aim to reduce morbidity and mortality in the population through the early detection of disease and treatment, both of which greatly improve health outcomes. It is important, therefore, to take up the offer of screening, which is free and simple and could save lives. The Minister is committed to the further expansion of screening in accordance with internationally accepted criteria and best practice.

I stress that awareness campaigns are very important, as is the infrastructure in our hospitals to be able to support them. As someone who comes from Galway, where we do not have that infrastructure, I fully concur it is important to have not only screening but also the relevant infrastructure in our A4 hospitals.

Colm Burke (Cork North Central, Fine Gael)
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I might just add that the comparative report on cancer in Ireland published by IHE, a Swedish institute, sets out clear comparisons. We should also learn from those kinds of reports to develop new strategies for cancer care in this country. While we have achieved a lot, we still have a lot to learn in this area.