Mary Henry (Independent)

It must be dreadful for them and some telephoned me to say how distressing it was. Mammography is not available to people with medical cards, another area in which people from poorer backgrounds are discriminated against. The Tánaiste has plans to role out the programmes but there is no sense of urgency. How many of the 650 women who died prematurely in each previous year due to breast cancer might be alive if BreastCheck were in place — 100, 200? I do not know but people lose decades of their lives because of late diagnoses.

The European code against cancer recommends screening for people over 50 years for colorectal cancer, the second most common cancer in both women and men in Ireland. Early diagnosis improves survival rates. For years, gastroenterologists have been asking for the establishment of a pilot scheme for faecal occult blood testing, tests in which people send in containers of faecal specimens over three consecutive days to determine if there is blood in them. If there is, something can be done via colonoscopy to determine whether the person has a tumour. Almost 2,000 Irish people are diagnosed each year with colorectal cancer, the same incidence as that of the United States of America, but the survival rates there are 26% better.

Lifestyle and environmental factors are important in the development of cancer but up to 10% of cases have a genetic predisposition, particularly so in two of the cancers I have mentioned. Women who have BRCA1 or BRCA2 genes or close relatives who have been diagnosed with breast cancer have higher chances of developing the disease, particularly at young ages. These people can only be seen and tested in a small number of family clinics in order to determine whether they have the gene mutation but there is an 18-month waiting list. What must those people who wonder whether they are at risk feel while this is happening? The same is the case in respect of colorectal cancers, in which two genetic conditions — hereditary nonpolyposis colorectal cancer and familial adenomatous polyposis cancer — are due to mutations of a particular gene. This country is at the forefront of genetic research in these areas but our people are not getting the benefits.

The Tánaiste knows that I have always supported her initiatives and those of her predecessors in setting up specialised units for the treatment of cancer. Our poor survival rates can be influenced by times of diagnosis but are also affected by the small unspecialised units around the country. I have implored politicians in this House not to ask for the continuation of these clinics and to think of the outcome for the people in their areas, not votes. Small units without proper team approaches are not getting the same results as larger centres. It is all very well if the medical profession must be taken on and politicians and the public must be educated. Our public and private patients deserve access to the best possible specialist treatment, which they are not getting. Instead, they are getting late diagnoses.