Phil Prendergast (Labour)

We are great at keeping an eye on our cars and phones. We are quick to upgrade and update them, have them checked out and put on new wheels. However, we are not as great when it comes to ourselves. Senator Feeney spoke at length about the embarrassment in respect of bowel cancer. Perhaps it is because I have been so surrounded by issues in respect of the body that I have no embarrassment in discussing cancer of any part of the body. In the course of my career I have encountered issues in respect of vulval cancer and cancers in areas which are difficult to treat. If exposure is part of the treatment it is even more difficult to treat. Sensitivity aside, it is a very important subject for debate. Public attitudes are very relevant.

The work of the Irish Cancer Society in promoting the issue with some very high-profile figures is warranted and welcome. I extend a very warm welcome to the former Senator, Ms Kathleen O'Meara, and the other members of the society present in the Visitors Gallery. It is great to see them any time, but especially important in highlighting this issue. The survey conducted by the society last summer, which has been emphasised, revealed 36% of people could not name a cancer symptom and 25% of people did not know what factors could increase the risk of developing bowel cancer. It was startling and alarming that such a common ailment is so little understood.

The health authorities in the UK have taken a simple step to reduce the rate of fatalities from bowel cancer by distributing a self-testing kit as part of a national screening programme. The fecal occult blood test, FOBT, is sent to people who simply provide a sample and send it to be tested. If a blood trace is found, they are invited for a colonoscopy. The test should be repeated every two years and is expected to detect approximately half of any bowel cancers according to the Institute of Cancer Research in Britain. Occasionally there are false positives if a person has haemorrhoids or piles, which can sometimes bleed. This may lead to a false positive and, obviously, it is a mater of great relief upon being told this is the case.

The FOBT is a good, cheap test. During trials of the test in Scotland, the positive predictive value was 10.9% for cancer and exactly 35% for adenoma. Adenoma is benign but if untreated can lead to cancer. It is a very simple and inexpensive process and will save money in the long run. Early detection of cancer can reduce the need for invasive surgery. The testing kit consists of little more than a cardboard swab and a cardboard receptacle. In the USA each test costs $5, such that there is no comparison to the cost of visiting a general practitioner, although I am not advocating cost as a factor for not going to the GP. In the UK the scheme is currently aimed at the highest risk group, namely, those between 60 and 69 years of age and it will gradually be rolled out to other target groups. In Canada, the scheme is free for over 50s and kits are given out at health centres. As Ireland does not have such a scheme, the Irish Cancer Society hopes that bowel cancer awareness month will help with its call for a screening programme. This is supported by the Minister of State, Deputy Killeen, who is still recovering from bowel cancer. We wish him and everyone diagnosed with any type of cancer or illness well. I am glad to add my voice to the campaign, which is something that the HSE should focus on instead of giving a mere endorsement.

Given that nearly 300 patients have been on colonoscopy waiting lists for more than six months and more than half of bowel cancers are diagnosed late, testing must be implemented as a matter of urgency. In Canada, it is reckoned that 90% of bowel cancer is curable when detected early. This means that nearly 800 people are dying needlessly in this country, which is an appalling statistic. Everyone would be shocked by a mass of 800 deaths, but that is the number involved.

The UK has committed to and is rolling out a national programme, which is due to start in Northern Ireland this year. As long ago as 2003, Dr. Richard E. Schabas, the then chief of staff at York Central Hospital in Ontario, analysed the evidence of regional screening programmes and concluded that "colorectal screening with FOB testing is simply too good an opportunity to ignore". The institutes of health research in Canada conducted a cost benefit analysis of the scheme that it has been running for 50 to 74 year olds since 2000 and it concluded that screening appears to be cost effective under all the scenarios considered. That was in 2007.

Our system is failing dismally in terms of health outcomes and, given the evidence, cost effectiveness. It is slow and cumbersome, with half of all diagnoses being for late stage cancer. This means that the cost of treatment is more expensive than the treatment for early stage detection. It is also contrary to the philosophy outlined in the cancer control strategy, which supports screening for bowel cancers and the further benefits of early detection initiatives. The latter educate the public about recognising symptoms, performing self-examination and the importance of early presentation of symptoms to doctors. While bowel cancer screening is not perfect, it is a better system than the current one and I call on the HSE to start implementing it.