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Cervical, breast and bowel cancer screenings in Ireland operate at best global standards, reports find

The reports, authored by Prof Susan O’Reilly and Prof Risteárd Ó Laoide, were published today.

Image: Shutterstock/Beate Panosch

REPORTS INTO THE performance of Ireland’s three main cancer screening services have found that the programmes perform equally well or better than similar screening programmes in other countries.

These reports were commissioned following a CervicalCheck audit of the smear tests of women who later developed invasive cervical cancer in the first few years of the programme.

Issues with the CervicalCheck system first came to light 
in 2018 following what were inconsistent disclosures of the audit results to patients – some women were not told that their smear tests had been part of an audit (a standard part of the screening service), nor were they given the option to find out the results of that audit.

A subsequent inquiry led by Dr Gabriel Scally made recommendations which included emphasis on quality assurance, the importance of auditing, open disclosure with patients, and improved linkage with the National Cancer Registry.

The National Screening Service (NSS) – which runs Ireland’s bowel, cervical, and breast cancer screening services – welcomed the publication of the Expert Reference Groups’ Interval Cancer Reports today.

The NSS said it would work to implement recommendations in the report “in full”.

The expert reports were commissioned as part of the Scally Review in 2018. They set out a new approach to reviews of ‘interval’ cancers in people who have been screened by Ireland’s breast, bowel and cervical cancer screening programmes.

NSS Chief Executive Fiona Murphy said today:

An interval cancer is one that is diagnosed in a person who has been screened previously. While they are uncommon, they show how every screening programme has limitations, and cannot detect every case of cancer.

“The NSS welcomes the detailed work undertaken by the expert groups, and we commit to a careful, thorough and full implementation of each of the recommendations.”

The NSS said:

The expert reports acknowledge that Ireland’s screening programmes operate to the best international standards and that they reduce deaths from cancer among people in Ireland.

“They affirm that world class screening programmes must balance patient trust, staff recruitment and affordability, and that interval cancers are an inherent feature of any screening programme.”

Reaction from stakeholders

Dr Colm Henry, Chief Clinical Officer of the HSE said that the HSE has now implemented more than 90% of Dr Scally’s report.

In 2018, the Scally reports into CervicalCheck made 58 recommendations shared between the HSE, the Department of Health and the National Cancer Registry of Ireland. The HSE is responsible for 42 of these recommendations.

Henry said that today “marks an important milestone in that process”.

I want to thank both Prof Risteárd Ó Laoide and Prof Susan O’Reilly, and all those who worked on these reports. Their work will contribute to improving further our screening services, which make such a real and substantive contribution to reducing the incidence of cancer in the Irish people.

BreastCheck report chair Professor Risteárd Ó Laoide of the NCCP said: “Evidence from international accreditation, international expert opinion, and review of BreastCheck – the National Breast Screening Programme has confirmed that the breast screening programme in Ireland is operating to the best international standards.

Breast screening reduces the number of deaths from breast cancer in Ireland by approximately 120 per year.

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CervicalCheck and BowelScreen reports chair Professor Susan O’Reilly said: “It has been my privilege to work with the professionals, patients, advocates and international experts who participated in this complex and sensitive project. I would like to thank all of them for their engagement in the development of the recommendations in our reports, which we are now pleased to publish.”

Patient advocate review group member Bridget Doherty said: “I am happy that the NSS has undertaken to implement all of the reports’ recommendations, and that the screening programmes are committed to working in partnership with patients as they make these important next steps.”

Donal Buggy, Irish Cancer Society, Director of Services Delivery said: “These reports contain recommendations which will strengthen the BreastCheck, CervicalCheck and Bowel Screen services’ approach to the categorisation and reporting of interval cancers. The Irish Cancer Society looks forward to the full and early implementation of the recommendations.”

Dr Gabriel Scally said: ‘’I was impressed by the quality of the reports and pleased to note the public and patient representation on the working groups. I hope, for example, that the results of the international survey of cervical screening is published in the professional literature.

“I was pleased also to see the support for reform in the legal system being voiced, and changing the approach for all screening services would be a good place to start.’’

The three reports can be found here:

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