Gino Kenny urges breast screening expansion to ages 45-74

Thanks for taking this very important subject matter. Minister, the European Commission recently published a new study in relation to breast cancer screening across the EU. One of its recommendations was to extend breast cancer screening to include women from the age of 45 to 74. As you know, in Ireland the screening process begins at 50 and ends at 69. So obviously the European Union are saying look for better outcomes for obviously women, the screening process should be lowered down to the age of 45, starting at 45 and ending at 74. And the figures are quite kind of I suppose compelling and the evidence is quite compelling in relation to breast cancer in Irish women. So one in nine women will develop breast cancer over their lifetime. Now obviously recovery is extremely high, extremely high and that's very, very important. But the startling kind of statistic is that 23% of all them women that are detected with breast cancer are actually under the age of 50. Between 20, between 20 and 50, so it's 23%. And then 36% of women in all that are diagnosed over 70. So that makes 56% of women that are not in that screening kind of process. So I mean the evidence I think is quite compelling in relation to lowering the screening age for women and for example some European countries start the age screening at 45. In Sweden, there's a very, very good example. They start at the age of 40. And what they have found is that when they started the process screening at 40, there was 26% less deaths. And that's quite good. And I know the National Screening Advisory Board has stated that they will prioritise the proposal by the European Commission. So my question is, you know, will you obviously take on the European Commission's report, you know, will you review the present screening process and what women will be actually asking for is will you lower the age of screening in relation to the European Commission's recommendations? Thank you. Thank you for raising this really important issue and it's great to get the opportunity to discuss it. The Minister and I 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. So as a woman, when you turn 50, you get the notification to attend your breast check, and I have to say the take-up is really, really high, which is great to see. And there's many, many people who are screened there and who find that they, you know, they might be challenged with breast cancer. And as you said, Deputy, the outcomes are really, really good. As you know, decisions about population-based screening in Ireland are made on the advice of the National Screening Advisory Committee. This independent expert committee makes recommendations to the Minister and the Department of Health on population screening in Ireland. As you 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, there are ethical, legal and societal issues which arise when planning an enduring population-based screening programme of this nature. So as you've said, Breast Check currently invites women aged 50 to 69 for screening, extending the programme to those up to the age of 69 was a programme for government commitment, which I am pleased to note has been met and has now been implemented. The NSAC's first annual call in 2021 for proposals for new screening programmes, or changes to our existing programme, received over 50 submissions. This included proposals on expansion of the age range eligibility for breast cancer screening from a number of sources, including from the Breast Check programme. The NSAC have asked HICRA to look at the evidence for the expansion of the age range of eligibility for breast screening to women between 45 and 74 years of age. And preliminary scoping work has begun, and I would agree with this wholeheartedly. I think it would be very important to extend the range. I had one person contact me who contracted breast cancer at the age of 45, and she was lucky, she was proactive, and she went about it. But the point she felt was there's many more who have breast cancer who don't realise they have it. And just to the point you made, Deputy, you know, I think at the age of 45, personally, I think it's a really good age to start. And I'm delighted that the Breast Check programme have endorsed this as well. You will be aware that under Europe's beating cancer plan, a proposal for an updated European Council recommendation on cancer screening was adopted by the Commission in September last. The final recommendation is expected to be formally approved by the Council of Europe on the 9th of December and then published. The NSAC will consider the recommendation and advice the Minister and the Department of Health on the evidence as it applies to Ireland, including in relation to breast screening. It is important to remind that screening is for healthy people without symptoms, and I would advise anyone to take up their invitation for screening when they receive it. It is important that every woman is breast aware, and this means knowing what is normal for them, so that if any unusual changes occur, they will recognise it. In light of this, I trust the public can be assured of the Minister's and my ongoing commitment to further expansion of population-based screening in Ireland. And I believe, Deputy, it can't happen soon enough. I think it's such an important thing. And you pointed out there the amount, 23% under 50 and 36% over 70. And I think by expanding it to those extra nine years, it could have a lot of positive outcomes for women's health. I think that sounds relatively positive. Obviously, this takes time and obviously more resources and obviously kind of the screening programme, because I was on the Health Committee and experts were kind of brought into the Health Committee talking about the pros and cons of a kind of extending screening process. And it was very kind of compelling in some ways, and obviously it's less evasive in relation to the screening process. Just another kind of issue, Minister, is in relation to women seeking early diagnosis. I know it's quite lengthy in relation to women trying to get an early diagnosis. Sometimes that could run into years, getting an early diagnosis. And, you know, in relation to cancer of any form, early prognosis and diagnosis is extremely, extremely important in relation to this. So, I think, look, I think it's positive. I think the outcomes in relation to the European Commission report and obviously the National Screening Advisory Board, I think they've taken that on. I think there is compelling evidence that lowering the age to 45, it will, look, as I, look, if it saves one life, Minister, one life. If there's one person that's watching this here and is saved, it's worth it. Anything is worth it to save one life. So, I think I'm quite positive. Obviously, there is extra costs, resources, but I think the Department of Health and the National Council for Early Screening Advisory Board, I think we're willing to take that on and hopefully we'll implement this as soon as possible. Thank you, Deputy, and thank you for raising this. And, look, I think what you said, if it saves one life, it's very important. And I suppose I just want to reiterate the importance of people when they are invited to a screening appointment that they take it up. 13,000 people in Ireland actually have skin cancer every year or are diagnosed with skin cancer, and I was one of those people this year. And thankfully, even though I had a malignant tumour, I was lucky that I got the all clear recently after two procedures. And I suppose it really does focus your mind when you realise that there are some really, really good positive outcomes if it's caught early enough. And I do believe that the latest cancer trends published by the National Cancer Registry, Ireland, focuses on cancers which are currently screened for, including breast cancer. The report highlighted the positive effect breast check has had on breast cancer incidences and mortality in Ireland. And the Minister and I are committed to the further expansion of screening in Ireland, and it's something I'm going to keep a close eye on, because I do think the points you made, to extend it to 45 and maybe 74, obviously, you know, everything, population-based screening programmes, they have to be considered thoroughly and carefully and assessed against international accepted criteria. But I think all the criteria and international best practice is all going in the same direction. So I'd be very positive that we'll be able to move on this, and thank you for raising it, Deputy.