PLANS BY the National Cancer Screening Service (NCSS) to extend BreastCheck to older women are now uncertain as a result of the downturn in the economy, it has emerged.
At present, the breast cancer screening service is offered to women aged 50-64 years and the board of the NCSS had taken a policy decision to extend it to females aged 65-69 once all women in the younger age group, including those in the south and west, had been offered their first round of screening by late 2010.
It would therefore be ready to begin screening older women in 2011, something which had also been recommended in the most recent national cancer strategy, published in 2006.
The board of the NCSS had meanwhile also sought a review in relation to whether BreastCheck might be offered to women under 50 years.
That internal review carried out by epidemioligist Dr Patricia Fitzpatrick and seen by The Irish Times concludes that while the service would be of some benefit to younger women, the merits of extending the programme to them is still a matter for debate. “With the advent of digital mammography, there may be merit extending the age limit to a younger age, as in the NHS, and removing the arbitrary limit of 50. However, there remains some controversy in the NHS itself regarding this decision,” it said.
Tony O’Brien, chief executive of the NCSS, said the review did not change the overall view that the case for extending the programme to older women was still stronger than extending it to younger women “even though the case for extending the age downwards is now stronger than it used to be”.
He explained that while there was more evidence now for decreasing the age, this did not outweigh the evidence for extending it to older women first.
But he said when the review was conducted last year to see whether younger women should also be included in BreastCheck, resources were not the issue they are now. “In that context it remains uncertain whether or when the age change for BreastCheck will change in any direction,” he said. He added that changes to the age group covered by the programme now also had to be looked at in the context of the need for a bowel cancer screening programme.
In June, the Minister for Health Mary Harney asked the Health Information and Quality Authority (Hiqa) to examine all resources involved in cancer screening to see if a way could be found of rolling out a national bowel cancer screening programme within existing resources. Hiqa’s report is due to be furnished to the Minister before the end of this month.
The aim of BreastCheck is to reduce deaths from breast cancer by finding and treating the disease at an early stage. To be effective it is imperative that women attend their screening appointment when invited. However, Ms Harney told a cancer conference in Dublin last week that up to 30 per cent of women called for screening, which is free, do not avail of it.
The first annual report from the NCSS published last year indicated BreastCheck had provided almost 450,000 free mammograms to more than 206,800 women and detected over 2,700 breast cancers up to September 2008. The programme began in the eastern region in 2000.
According to the National Cancer Institute in the US, the risk of breast cancer rises with age from 1:220 in the 30s age group to 1:50 in the 40s age bracket and 1:35 in those over 50.