(Limerick East): The programme A Government of Renewal contains a commitment to expand the Eccles pilot breast screening programme on a phased basis. However, it was necessary to await the independent evaluation of the report from the Eccles programme on the epidemiological aspects of breast cancer screening. That evaluation report supports the introduction of a breast screening service, subject to the establishment of a population register. I was pleased, therefore, to be in a position to formally announce the phased expansion of the programme at the launch of Europe Against Cancer Week on Friday, 6 October 1995.
The decision to proceed on a phased basis is guided by the need for 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. It is my intention to ensure that the phased introduction of the breast screening programme takes cognisance of these critical success factors.
As Deputies will be aware, there is an international debate surrounding the efficacy of the breast screening programmes. The debate centres on a number of key issues including: the impact on mortality of breast screening programmes; the concerns associated with false positive and false negative results; and the cost effectiveness of the breast screening programmes. I am confident that the phased introduction as I already outlined will address these concerns.
The question of whether the introduction of a national breast screening programme will impact significantly on mortality levels cannot be answered in the short-term. However, the evidence from international clincial trials suggests that reductions can be achieved through breast screening. For now, the emphasis must be on putting in place a programme which achieves the highest standards of quality at all levels. The staging of the programme will be related to the achievement of performance targets in line with these quality measures.
It is my intention that the first phase of the programme will commence as soon as possible and will cover the Eastern, North Eastern and Midland Health Board areas. It will target 120,000 women in the age cohort 50 to 64 which represents 50 per cent of the national target population.
The Eccles pilot breast screening programme has been recognised by the European Network of Reference Centres for Breast Cancer Screening as a centre of excellence. The decision to include the Eastern, Midland and North Eastern Health Board areas in phase 1 was based, primarily, on the need to draw on the clinical expertise which has been built up in the Eccles programme.
Officers of my Department will shortly be meeting the director and senior staff of the Eccles pilot programme to agree a detailed work programme, costings, management and evaluation arrangements for this phase. The development of a comprehensive population register will be an essential step in this programme.