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Cancer Screening Programmes

Dáil Éireann Debate, Tuesday - 25 March 2014

Tuesday, 25 March 2014

Questions (1120, 1121, 1122, 1123, 1124, 1125)

Arthur Spring

Question:

1120. Deputy Arthur Spring asked the Minister for Health further to Parliamentary Questions Nos. 257 and 258 of 13 March 2014, if the review published in the AJR in 2009 was not a case-controlled clinical trial, with women randomly assigned to machines and not consulted. [13720/14]

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Arthur Spring

Question:

1121. Deputy Arthur Spring asked the Minister for Health further to Parliamentary Questions Nos. 257 and 258 of 13 March 2014, if he views the statistically significant increase in breast cancer incidence which occurs with each screening as a positive. [13721/14]

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Arthur Spring

Question:

1122. Deputy Arthur Spring asked the Minister for Health further to Parliamentary Questions Nos. 257 and 258 of 13 March 2014, if the increase in recall rates is laudable. [13722/14]

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Arthur Spring

Question:

1123. Deputy Arthur Spring asked the Minister for Health further to Parliamentary Questions Nos. 257 and 258 of 13 March 2014, if he will confirm that digital mammogram images can be manipulated. [13723/14]

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Arthur Spring

Question:

1124. Deputy Arthur Spring asked the Minister for Health further to Parliamentary Questions Nos. 257 and 258 of 13 March 2014, if these images can subsequently be used to confirm a diagnosis of cancer. [13724/14]

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Arthur Spring

Question:

1125. Deputy Arthur Spring asked the Minister for Health further to Parliamentary Questions Nos. 257 and 258 of 13 March 2014, if the guidelines for quality assurance also include information that a standardised detection ratio is the preferred method for ensuring unit performance, and if unit performance supersede women's health. [13725/14]

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Written answers

I propose to take Questions Nos. 1120 to 1125, inclusive, together.

The review published in the American Journal of Radiology in 2009 entitled Comparison of the digital mammography and screen-film mammography in breast cancer screening: A review in the Irish breast screening program was not carried out as a 'case controlled clinical trial'. This study reviewed the use of full-field digital mammography (FFDM) in a population-based cancer screening programme and compared the results with screen-film mammography. The study involved 188,823 screening examinations of women aged between 50 and 64 years. Of these 35,204 (18.6%) were obtained using full field digital mammography (FFDM). The re-call rate and cancer detection rate of FFDM were compared with results from screen-film mammography. In this study FFDM gave rise to significantly higher cancer detection and recall rates than screen-film mammography.

Digital mammography facilitates enhancement of image quality which is particularly associated with improved visualisation of dense breast tissue. The improved images lead to higher detection rates for cancer which is seen as a positive. This facilitates earlier treatment of known cancers. Digital mammography does not play any part in causing these cancers.

Furthermore, digital mammography results in significant reductions in the radiation dose associated with screening examinations and it allows images to be acquired in a shorter time. It is also possible to manipulate the examination of images from different angles to obtain better detail.

A standard protocol for viewing mammograms is routinely used in all the BreastCheck units. BreastCheck offers a triple assessment approach to diagnosis which involves a combination of clinical examination, additional imagery (mammography or ultrasound) and cytology. The standardised cancer detection ratio is assessed centrally by the Programme Evaluation Unit for the entire BreastCheck programme. The health of women is at the centre of all aspects of BreastCheck. Also BreastCheck provides transparent information to women who are invited for screening - with the benefits and limitations of screening clearly explained.

The latest projections from the National Cancer Registry indicate that the incidence of cancer, including breast cancer, in Ireland is expected to rise in the period up to 2040. They attribute this in the main to demographic changes such as population size and an aging population. Breast cancer survival in Ireland has improved significantly in recent years due to a combined approach of screening, symptomatic detection and improved treatment. Breast cancer 5 year survival is now estimated at 81.8% for people diagnosed between 2003-2007, up from 76.8% for people diagnosed between 1998-2002.

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