Marie Sherlock (Dublin Central, Labour)
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150. To ask the Minister for Health for a clear timeline as to when the HIQA review on a breast density notification within the BreastCheck Programme will begin; when it is expected that it will make its conclusions and report back to her; and if she will make a statement on the matter. [24019/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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As Minister for Health, I am committed to supporting our population screening programmes, which are a valuable part of our health service, enabling early treatment and care for many people, and improving the overall health of our population.

BreastCheck, the National Breast Screening Programme, currently invites women aged 50 to 69 years at regular periods to have a mammogram. The Programme for Government commits to raising the age for the BreastCheck screening programme in line with updated standards from the Health Information and Quality Authority (HIQA).

I would note that changes to Ireland’s screening programmes will be facilitated through established evidence-driven protocols. The National Screening Advisory Committee (NSAC) is the independent expert group that considers proposed changes to Ireland’s screening programmes. NSAC assesses the evidence in a robust and transparent manner, and against internationally accepted criteria, before making recommendations to me as Minister. The rigorous processes utilised by NSAC are critical to ensure that our screening programmes are effective. This is particularly important when expert opinion is divided, and uncertainty remains about whether the potential benefits outweigh the possible harms.

With regards to breast density specifically, while some countries have introduced this into their screening programmes, there are significant differences in international clinical opinion on the effective incorporation of standardised notification into breast cancer screening. The recently updated ‘European Commission Initiative on Breast Cancer: European guidelines on breast cancer screening and diagnosis’, highlight the low certainty of evidence surrounding the incorporation of breast density measurement into population health screening programmes. This contrasts with the recommendation of the European Society for Breast Imaging (EUSOBI), which recommends that women with extremely dense breast tissue are offered screening with breast MRI.

This lack of consensus explains the need for a cautious, evidence-led approach to ensure that any decision serves the best interests of the population and maintains the integrity of the screening programme.

In this regard, I am pleased to report that NSAC is progressing work to consider the further expansion of our cancer screening programmes and has submitted a request to HIQA, which has a section dedicated to undertaking evidence synthesises on behalf of the Committee, to assess whether there is evidence for a further expansion of the BreastCheck programme. The review will focus on two key elements: the expansion of the age range eligibility and the potential introduction of a standardised breast density measurement.

HIQA is currently focused on two Health Technology Assessment (HTA) processes underway to examine the expansion of the BowelScreen programme and the potential development of a population-based screening programme for Abdominal Aortic Aneurism (AAA). The evidence review for the expansion of BreastCheck remains a key priority for NSAC and is expected to commence later this year.

HTAs facilitate the assessment of relevant evidence and knowledge on the effects and consequences of healthcare technologies to guide decisions regarding the appropriate use of technology and efficient allocation of resources. They involve a multi-disciplinary assessment of the clinical, economic, ethical, legal and societal perspectives that may be impacted by the introduction of a new technology. They are time intensive and rigorous processes. Both elements of the BreastCheck review are anticipated to be complex and will take time to ensure that any recommendations made to me by NSAC are underpinned by a robust evidence-basis.

Significant investment continues to be made in our national screening programmes. This includes allocating an additional €2.9 million in full-year costs to BreastCheck for 2025. This funding will help to future-proof the programme, allowing for increased capacity and enabling service developments to meet women's evolving needs and ensure equitable access across the entire population.

Finally, I would emphasise that population-based screening programmes are for people without symptoms. If anyone becomes aware of symptoms, or if they have concerns or worries, they should contact a medical professional.