It will take years to clear breast cancer screening backlog
Number of late diagnoses set to soar, warn experts
IT will take years to work through the backlog of BreastCheck screenings that built up during the pandemic, HSE officials told an Oireachtas committee yesterday.
This could led to later-stage diagnoses, The Irish Cancer Society yesterday warned.
Just 56,000 women were screened by the State cancer service last year, less than one third of the 2019 figure.
More than 70,000 women have been screened so far in 2021, with rates returning to normal in September for the first time since the start of the pandemic.
Rachel Morrogh, director of advocacy with the Irish Cancer Society, told the Irish Daily Mail that many people had contacted the charity ‘outlining their anxieties’ about how disruptions to screening could affect them.
‘The pandemic has had a devastating impact on all cancer services and this includes cancer screening,’ she said.
‘It is estimated that one million cancer screenings have not taken place across Europe since March 2020 and experts have warned that this could lead to later-stage diagnoses.
‘It is essential that the national screening service continues to be supported with whatever resources it needs to recover from the impact of the pandemic, including returning to a two-year programme as soon as possible,’ she added.
BreastCheck representatives also told the TDs and senators that while there is no data yet on people presenting to doctors with more advanced cancer following disruptions to the screening service, there are ‘anecdotal reports’ of such cases.
Responding to a question from Sinn Féin TD Mark Ward, BreastCheck lead clinical director Fidelma Flanagan said that the cancer check-up service had rearranged its scheduling and adapted mobile units to ramp up screening and get through the backlog.
Referring to the number of women to be screened, Ms Flanagan said ‘there is no doubt it is going to be challenging’.
She told committee members: ‘We’ve lost a year ,and the fact that we’re back to pre-Covid levels while there are still restrictions suggests that we’re doing more with what we normally have.
‘So the measures that we’ve taken to screening have already had an effect.
‘But we have to accept that Covid-19 has had a major disruption to screening and we have to accept it is going to take three years to get round this round.
‘It will take years to fully recover from this but each time we go around our cohort of women that will be reduced and our absolute priority is to drop that back to the two-year programme.’
While women are normally invited for a screening every two years, BreastCheck previously confirmed that screenings are
‘Pandemic had a devastating impact’
now every three years due to the Covid build up.
Ms Flanagan explained when BreastCheck suspended screenings for nine months during the pandemic, resources were diverted to the HSE’s symptomatic service where women who have symptoms, such as lumps, are referred by their doctors.
She said these women have a higher risk of having cancer, while those attending BreastCheck have a far lower risk.
‘To put a figure on it, if we screen 1,000 women [at BreastCheck], we’d expect to pick up seven patients with breast cancer.
‘If we assess, in our symptomatic services, 1,000 women, we will pick up 100 women,’ Ms Flanagan said.
In response to a query from Fine Gael senator Martin Conway, Ms Flanagan urged women who feel any sort of lump on their breast: ‘Please don’t wait for your invitation. Go to your doctor, be referred to our symptomatic services. That’s the message we have to get out – rather than sitting, waiting, knowing we are slightly behind in the screening process.’
Currently BreastCheck is offered to women aged between 50 and 70 but it is considering widening the age range, Ms Flanagan told the committee.
‘We follow the science in BreastCheck all the time but the incidence is obviously there in the older age group and we’re always looking to see should we be extending our programme-beyond the current age range which is 50 to 70.
‘If you look at the evidence at the moment, it looks like it’s changing, it’s dynamic.
‘It looks like there are additional recommendations that we should be offering screening to the over-70s and also to the under-50s. We are definitely looking at that.
‘We were temporarily a bit distracted given Covid and delivering the service as it is but that is definitely on our radar.’
Professor Arnold Hill, national adviser with the National Cancer Control Programme, told the committee there was no official data on the number of patients diagnosed with later stages of the disease following on from the pandemic.
‘There are anecdotal reports of some patients coming in with more advanced disease but we need to wait until we get the full data on that,’ he said.