HSE briefing on cancer check reports about to kick off #iestaff

HSE has carried out 107 of 116 recommendations regarding screening services since the Scally report in 2018, says Dr Colm Henry

Risteard O Laoide, who led the report into Breast Check, is speaking. More than 13,000 cases of breast cancer have been discovered since the programme's inception in 2008, he says

Ireland's rate of interval breast cancer - that is cancer presenting between screening processes, a thorny subject - is 2 per 1,000. 340 such cases in Ireland per year

40% of people presenting with interval cancer do not wish to have their case reviewed, Professor O Laoide says. Report recommends an anonymised process for "programmatic review", so that the maintenance of data or results in the face of a lack of patient consent isn't an issue

Prof Susan O'Reilly is talking about the cervical check interval report now. 260 women are diagnosed with such cancer in Ireland each year, and 90 women die. Just under half of those diagnosed are aged under 45

HPV testing was introduced in March of this year. Of 1,000 women screened 20 will have precancerous changes. HPV will catch 18 of these, previous cytology testing would have caught 15

There's no international consensus or standardised approach to clinical audit of interval cancers, or to disclosure of patients, a lack of disclosure having been a major issue highlighted by the Cervical Check scandal

Cervical Check is to plan and implement patient-requested reviews of invasive interval cancers, O'Reilly says

3,000 people are diagnosed with bowel cancer in Ireland each year, 1,700 men and 1,300 women

Bowel Screen is to practice full disclosure with regard to patients diagnosed with interval cancer

Recommendations on foot of the reports include: to build understanding and trust in screening programmes; to propose a legal framework for screening; to provide access to patient-requested reviews

Key change going forward is that anyone presenting with an interval cancer will be given the option of a review of their case. That'll be a first for Cervical Check which has never previously had the option. Bowel Screen always did #iestaff

Implementing anonymised programme reviews is highly complex technically, mainly because giving a result to the wrong person is "something that cannot happen", says Professor Ann O'Doherty, head of BreastCheck

Cervical check reviews "will take time to develop" says O'Reilly, as all will also have to be externally reviewed.

In terms of how screening is looking under Covid, cervical check is "nearly caught up", Bowel Screen has caught up with all people waiting for an endoscopy, Breast Check they're hoping will be back up before end October

Breast Check has an additional problem when it comes to effective social distancing, says Fiona Murphy, CEO of National Screening Services

Of 17 programmes internationally asked about disclosure of audits as part of this review, 14 don't disclose. One of the ones that does is England. Two reasons given for non disclosure are "not wishing to cause distress, and timing limitations"