Enda Kenny
Question:181 Mr. Kenny asked the Minister for Health and Children the incidences of breast cancer detected in each health board area for each of the past five years; and if he will make a statement on the matter. [9969/98]
Written Answers - Cancer Treatment Services.
Michael Ring
Question:189 Mr. Ring asked the Minister for Health and Children the number of women who have died in the past three years from breast cancer; and the steps, if any, he intends to take to ensure that this number is reduced in the years to come. [10007/98]
Michael Ring
Question:190 Mr. Ring asked the Minister for Health and Children the facilities in place for the detection and treatment of breast cancer in the Western Health Board region; and the plans, if any, he has to upgrade the services. [10008/98]
Michael Ring
Question:191 Mr. Ring asked the Minister for Health and Children the plans, if any, he has to commission a report into the reasons for the increase in the number of deaths from breast cancer in Ireland. [10009/98]
I propose to take Questions Nos. 181, 189, 190 and 191 together.
The National Cancer Registry Board collects information on the incidence of and deaths from cancer in Ireland. The first year for which national information is available is 1994. The following tables contain the information requested by the Deputies for 1994 and the subsequent years for which complete data are available.
New Cases of Breast Cancer recorded: 1994 and 1995
|
1994 |
1995 |
|||
|
Female |
Male |
Female |
Male |
|
|
EHB |
606 |
3 |
553 |
4 |
|
MHB |
91 |
0 |
98 |
0 |
|
MWHB |
123 |
0 |
143 |
1 |
|
NEHB |
103 |
0 |
100 |
0 |
|
NWHB |
109 |
3 |
92 |
1 |
|
SEHB |
129 |
3 |
162 |
0 |
|
SHB |
268 |
3 |
256 |
0 |
|
WHB |
155 |
2 |
148 |
2 |
|
Total |
1584 |
14 |
1552 |
8 |
Deaths from Breast Cancer 1994, 1995 and 1996
|
Females |
Males |
|
|
1994 |
638 |
5 |
|
1995 |
639 |
10 |
|
1996 |
609 |
6 |
I am committed to supporting all possible steps to reduce deaths from breast cancer. A national breast screening programme is currently at an advanced stage of preparation and it is hoped to commence screening in phase one of the programme later this year. I have funded a number of breast clinics under the national cancer strategy. The strategy provides an integrated and comprehensive approach to reducing the incidence of and deaths from all forms of cancer. I have provided £8.7 million in 1998 to continue implementation of the strategy, including £1 million for the national breast screening programme.
In relation to the facilities in place for the detection of breast cancer in the Western Health Board region, mammography machines are in place at University College Hospital, Galway and Mayo General Hospital, Castlebar. UCHG also operates a dedicated breast clinic.
To date, detailed information on death from breast cancer from the National Cancer Registry Board is available for three years only. Care must be taken in interpreting data over such a short period. The NCRB will continue to monitor trends in deaths from breast cancer and other forms of cancer in the coming year, and my Department will continue to support the board in its work.
Enda Kenny
Question:182 Mr. Kenny asked the Minister for Health and Children the arrangements, if any, there are to provide screening facilities for the detection of breast cancer in women in the Western Health Board area; if these arrangements are on a par with those in other health board areas; and if he will make a statement on the matter. [9970/98]
Enda Kenny
Question:183 Mr. Kenny asked the Minister for Health and Children the number of women screened for breast cancer in each health board area in each of the past three years; the proportion of women that this represents; and if he will make a statement on the matter. [9971/98]
Enda Kenny
Question:184 Mr. Kenny asked the Minister for Health and Children the extent of promotional activities implemented by his Department to make women aware of the breast screening facilities promoted by his Department and health boards; the plans, if any, he has for a continuing awareness campaign in relation to it; and if he will make a statement on the matter. [9972/98]
Michael Ring
Question:188 Mr. Ring asked the Minister for Health and Children when the national breast screening programme announced in November 1996 will be implemented countrywide and, in particular, in the Western Health Board region. [10006/98]
I propose to take Questions Nos. 182, 183, 184 and 188 together.
At present, in Ireland mammography is used primarily as a diagnostic tool for symptomatic or concerned women on referral from their GPs and in some cases for women at particular risk of developing the disease. Diagnostic mammography services are currently provided at 19 centres throughout the country, as per the following list.
Breast cancer screening involves the carrying out of mammography on a mass population basis. The aim is to lead to earlier detection and treatment of breast cancer in asymptomatic women. In Ireland, experience of breast screening to date derives from a pilot programme, known as the Eccles breast screening programme, which was established in 1989 by the Mater Foundation. The Eccles programme successfully demonstrated that a mammography screening programme is feasible in an Irish setting.
In March 1997, the then Minister announced the introduction of a major action plan to implement the proposals contained in the national cancer strategy. Included in the plan were proposals for the introduction on a phased basis of a national breast screening programme for women aged 50-64. Phase I will cover the Eastern, North-Eastern and Midland Health Board areas and I will target 120,000 women in the age cohort 50 to 65, which represents approximately 50 per cent of the national target population.
The decision to proceed on a phased basis is a reflection of the complexities involved in the screening process and the importance of ensuring that the Irish programme meets the necessary quality assurance criteria. As Minister for Health and Children, I am very much aware of the unnecessary trauma and anguish that could be caused for women and their families as a result of mistakes in an organised screening programme. It is for this reason that the Irish national breast screening programme must be driven by international quality assurance standards and best practice.
Specifically the phasing will take account of the following critical success factors: the achievement of acceptable compliance levels among the target population; ongoing evaluation of the programme from a quality assurance perspective; and availability of the necessary clinical expertise to conduct the programme.
A major challenge facing the programme was the need to establish a named population register which would comply with the data protection requirements. However, I am pleased to say that following the passage of the Health Provision (No. 3) Act, 1997, and subsequent correspondence with the Data Protection Commissioner, we are now in a position to proceed with the establishment of a population register for the programme. Work is well advanced on this issue and it is hoped to have the register in place by July 1998.
Since the launch of the cancer action plan, there have been a number of other important developments in relation to breast screening. These include: (i) the establishment of a national steering group, chaired by Dr. Sheelah Ryan, chief executive officer, Western Health Board, to guide the implementation of the national programme of screening for breast cancer, (ii) the establishment of a national quality assurance committee, chaired by Professor Ennis, consultant radiologist, Mater Hospital, as a subcommittee of the steering group — the committee is representative of experts from all the relevant clinical disciplines, and (iii) the decision to appoint a project director for the programme.
A key development in recent months was a decision by the breast screening steering committee on a model of delivery for phase I of the programme. It has been agreed that there will be two central units based at the Mater and St. Vincent's, where the screening, assessment and treatment of women will be carried out using a multidisciplinary team approach involving the relevant clinical disciplines, including the screening radiologist. In addition, there will be two mobile units to bring the screening services to the women in the more remote-rural areas within the three health boards in phase I. Each mobile unit will be linked with one of the central units. This should ensure uniformity of standards and continuity of care.
Key factors in ensuring compliance among the target population would be health promotion and awareness campaigns. The steering committee will be working closely with my Department's health promotion unit in this regard to ensure that women are fully aware of the benefits of participating in the screening programme.
Taking into account the lead in time involved in the development of IT systems, the establishment of the population register and the recruitment of consultant and support staff, I am advised that we should be in a position to start the programme by autumn 1998. I am committed to making the necessary resources available to the programme to facilitate the commencement of screening and substantial funding has already been made available in 1998 to meet the start up costs for the programme.
Decisions taken in relation to subsequent phases, which will include the Western Health Board area, will be guided by the experience gained from putting phase I of the programme in place. The steering committee has recommended that phase II of the programme should follow phase I as soon as is practicable.
Diagnostic Mammography Units
Hospital
Adelaide Hospital
Beaumont Hospital
Mater Hospital
St. James's Hospital
St. Vincent's Hospital
Ennis General Hospital
Letterkenny General Hospital
Limerick Regional Hospital
Mayo General Hospital
Nenagh General Hospital
Our Lady of Lourdes Hospital, Drogheda
Our Lady's Hospital, Navan
Portiuncula Hospital
Portlaoise General Hospital
Sligo General Hospital
South Infirmary-Victoria Hospital, Cork
Tralee General Hospital
University College Hospital, Galway
Waterford Regional Hospital