Mary Wallace
Question:60 Miss M. Wallace asked the Minister for Health the budgetary allocation he has reserved for expanding breast cancer screening during the next 12 months. [7800/95]
Written Answers. - Mammography Screening.
Mary Wallace
Question:61 Miss M. Wallace asked the Minister for Health the steps, if any, he is taking to develop a specific plan for the direct targeting of women for breast cancer screening. [7801/95]
Mary Wallace
Question:62 Miss M. Wallace asked the Minister for Health if his attention has been drawn to the fact that women in their late 20s who are referred by their doctor for a mammogram are frequently refused the procedure; and if he will make a statement on the matter. [7802/95]
Mary Wallace
Question:66 Miss M. Wallace asked the Minister for Health if his attention has been drawn to the fact that the North Eastern Health Board offered to facilitate the expansion of a region-wide breast cancer screening service in 1994; and the steps, if any, which have been taken by his Department to respond to this offer. [7806/95]
Limerick East): I propose to take Questions Nos. 60, 61, 62 and 66 together.
The Deputy will be aware that mammography screening involves the carrying out of mammography on a mass population basis to detect breast cancer in non symptomatic women. There is general agreement that mammography screening programmes are not effective in reducing mortality in younger women due to the density of breast tissue in this age group. For this reason, in cases of symptomatic younger women, a radiologist may recommend an ultrasound examination as an alternative to a mammogram and is generally more effective in this age group.
Consequently, mammography screening programmes tend to be directed at women aged between 50-65 years. There has been some debate regarding the effectiveness of mammography screening in reducing mortality from breast cancer. It is essential to establish whether a reduction in the mortality rate can be achieved in Ireland. For this reason, my Department has been supporting the Eccles Breast Screening Programme, which was one of a network of pilot schemes on breast cancer being carried out within the European Union.
The objectives of the Eccles Breast Screening Programme were:
—To evaluate the impact of mammographic screening on mortality from breast cancer among Irish women;
—To document compliance with a breast screening programme in Irish women;
—To compare the sensitivity, specificity and predictive value of the mammography programme with that reported internationally.
The programme was carried out in a defined catchment area, north Dublin and Cavan/Monaghan, representing both urban and rural populations. All women in the catchment area aged between 50-64 years were eligible to attend and were included in two rounds of screening. Written invitations suggesting a date for screening were issued and these were followed with a second invitation in cases of no response. The age group to be screened complied with EU criteria for such programmes.
I am aware that the North Eastern Health Board offered to assist the expansion of the screening programme. However, it was considered inappropriate to embark on any expansion of the programme before the results of the second round of screening had been evaluated.
It is generally accepted that the essential factor for the success of a national breast screening programme is a high and consistent participation rate among the population to be screened. Accordingly I am examining the scope for developing a comprehensive population register so that women may be specifically targeted for the programme.
TheGovernment of Renewal programme contains an undertaking to expand the Eccles Breast Screening Programme on a phased basis to cover those women in the higher risk group nationwide. A report on the programme's second round of screening was completed at the end of 1994 and submitted to my Department. This report is currently being evaluated and assessed. I expect to be in a position to announce a decision on the phased expansion of the programme in the immediate future and I have made provision in this year's Estimates for the necessary resources.