Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I thank the Leas-Cheann Comhairle for taking this important matter. The European Commission recently published a new study on breast cancer screening across the European Union. One of its recommendations was to extend breast cancer screening to include women from the ages of 45 to 74. As the Minister of State knows, in Ireland, the screening process begins at 50 and ends at 69. The European Union is saying that for better outcomes for women, the screening process age should be lowered to 45 and end at 74. The figures and evidence are quite compelling in respect of breast cancer in Irish women.

One in nine million women will develop breast cancer over their lifetime. Recovery rates from the disease are high, which is important. The startling statistic, however, is that 23% of all women who are detected are under the age of 50. Between the ages of 20 and 50, the figure is 23%. Some 36% of the women who are diagnosed are over 70. Some 56% of women then are not in that screening process. The evidence is, therefore, quite compelling in respect of the lowering of the screening age for women.

For example, in some European countries the age of screening starts at 45. Sweden, which is a good example, starts at 40. That country has found that when it started the process of screening at 40, there were 26% fewer deaths, which is a good result. The national screening advisory committee, NSAC, has stated that it will prioritise the proposal by the Commission. Will the Government take on the Commission’s report? Will it review the current screening process and, as women will ask for, will it lower the age of screening as per the recommendations of the Commission?

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this important issue and it is great to get the opportunity to discuss it. The Minister and myself are committed to supporting our national population-based screening programmes. As we all know, screening saves lives and it is important that decisions on changes to our existing screening programmes, such as changes to the age range eligible for screening, are made in line with international best practice.

When a woman turns 50, she receives a notification to attend her BreastCheck appointment and the take-up is very high, which is great to see. Many people who are screened find that they might be challenged with breast cancer. As the Deputy said, the outcomes are good.

As he may know, decisions about population-based screening in Ireland are made on the advice of the NSAC. This independent, expert committee makes recommendations to the Minister and the Department of Health on population screening in Ireland. As he may appreciate, the assessment of the evidence for making changes to screening programmes is a thorough process, done in line with internationally accepted criteria and with scientific rigour. In addition to the scientific and technological information required to make evidence-based decisions, ethical, legal and societal issues arise when planning an enduring population-based screening programme of this nature.

As the Deputy stated, BreastCheck currently invites women aged 50 to 69 for screening. Extending the programme to those up to the age 69 was a programme for Government commitment, which I am pleased to note has been met and is now being implemented. The NSAC's first annual call in 2021 for proposals for new screening programmes or changes to our existing programmes, received more than 50 submissions. This included proposals on expansion of the age range eligibility for breast cancer screening from a number of sources, including from the BreastCheck programme.

The NSAC have asked HIQA to look at the evidence for the expansion of the age range eligibility for breast screening to women aged between 45 and 74 and preliminary scoping work has begun. I agree wholeheartedly that it would be important to extend the range. One person contacted me who had contracted breast cancer at the age of 45. She was lucky in that she was proactive and went about dealing with it.

She made the point that many others have breast cancer and do not realise it.

I think that 45 years is a good age to start and I am glad that the BreastCheck programme has also endorsed this. Under Europe’s beating cancer plan, a proposal for an updated European Council recommendation on cancer screening was adopted by the Commission in September. The final recommendation is expected to be formally approved by the Council of the European Union on 9 December and then published.

The NSAC will consider the recommendation and advise the Minister and the Department of Health on the evidence as it applies to Ireland, including in respect of breast screening. It is important to remind ourselves that screening is for healthy people without symptoms and I advise everyone to take up their invitation for screening when they receive it.

It is important that every woman is breast aware. This means knowing what is normal for them so that if any unusual change occurs, they will recognise it. In light of all this, I trust the public can be assured of the Minister’s and my own ongoing commitment to further expansion of population-based screening in Ireland. It cannot happen soon enough. It is such an important provision.

The Deputy noted that it is 33% under 50 years and 36% over 70 years. Expanding the programme by those extra nine years could have many positive outcomes for women's health.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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That sounds quite positive. This will take time and more resources. I was on the health committee where experts were brought in to talk about the pros and cons of extending the screening process. The case was quite compelling. It makes it less evasive. There is also an issue of women seeking early diagnosis. I know it can be lengthy and can run into years. For any cancer, early diagnosis and prognosis is important.

The Commission's support for the new European Council recommendation is positive and I am glad NSAC has taken it on. There is compelling evidence for reducing the age to 45. If it saves one life, and if there is one person watching this is saved, it will be worth it. Anything is worth it if it saves one life. I am quite positive. There will be extra costs and resources but the Department of Health and the NSAC are willing to take that on and, hopefully, they will implement it as soon as possible.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for raising this. As he said, if it saves one life, it will be important. I reiterate how important it is that people are invited to screening appointment, they take it up. Some 13,000 people in Ireland a year are diagnosed with skin cancer. I was one of those people this year. Thankfully, even though I had a malignant tumour, I was lucky that I got the all clear recently after two procedures. It does focus the mind when you realise that there can be positive outcomes if it is caught early enough.

The latest cancer trends report, published by the National Cancer Registry Ireland recently, focuses on cancers that are currently screened for, including breast cancer. The report highlighted the positive effect BreastCheck has had on breast cancer incidence and mortality in Ireland. The Minister and myself are committed to the further expansion of screening in Ireland. It is something I will keep a close eye on because of the points the Deputy made in favour of extending the programme to those aged 45 and aged 74. Population-based screening programmes must be considered thoroughly and carefully and assessed against international accepted criteria but all the criteria and international best practice are going in the same direction. I am positive that we can move on this.