THE AGE THRESHOLD for Ireland’s BreastCheck programme is to be reviewed next year, according to the Health Information and Quality Authority (HIQA). 

It comes as an assessment has commenced of extending the country’s national colorectal cancer screening programme to those aged 50 to 54 by the agency. 

The national breast screening programme aims to invite women who do not have symptoms of cancer and who are aged between 50-69 for a free-of-charge mammogram every two years. 

Eligibility for the programme, which is aimed at the early detection and treatment of breast cancer, was expanded to women aged 69 in 2021.

New guidance issued by the US Preventive Services Task Force in April recommends that all women should start breast cancer screening at age 40 and this should be continued until age 74.

A spokesperson for HIQA told The Journal: “HIQA has received a request from the National Screening Advisory Committee (NSAC) to consider the evidence for a further expansion of the age range eligibility for the BreastCheck programme, following a prior expansion in 2021 to women aged 69.

“This assessment is expected to commence next year following completion of HIQA’s assessment for NSAC on the expansion of the BowelScreen programme to those aged 50 to 54 years.”

Minister for Health Stephen Donnelly confirmed that further expansion of the programme was being considered in a parliamentary question late last month.

He said that health Technology Assessments (HTA) facilitate the assessment of relevant evidence and knowledge on the effects and consequences of healthcare technologies “to guide decisions regarding the appropriate use of technology and efficient allocation of resources”.

“They involve a multi-disciplinary assessment of the clinical, economic, ethical, legal and societal perspectives that may be impacted by the introduction of a new technology. They are time intensive and rigorous processes,” Donnelly said. 

On average, 3,400 people are diagnosed with breast cancer each year in Ireland. 17% of all cases are in those aged 40-49, while 9% of those diagnosed with breast cancer are aged 70-74.

Directory of advocacy and communications at the Irish Cancer Society Steve Dempsey has welcomed the development. 

“In 2021, the Irish Cancer Society submitted evidence to the National Screening Advisory committee and recommended that the eligibility for both BreastCheck and BowelScreen be expanded. We are delighted to see our recommendations to expand the screening age for both programmes examined by HIQA,” he told The Journal. 

“Screening saves lives. It is a valuable tool that helps to catch cancers at the earliest possible stage, in people who are not experiencing signs and symptoms.

“We want to make sure that screening has the most impact possible for the population and await the outcome of the HIQA review.”

Delays

Appointments for the BreastCheck screening programme have been delayed following a pause during the Covid-19 pandemic, which has resulted in women not being screened every two years. 

The screening service was paused for several months at the beginning of the pandemic in 2020, and again between January and March 2021, in order to “protect participants and staff by complying with social distancing guidelines to prevent the spread of COVID-19”.

This pause in screening meant that women had to wait longer for their appointments.

In February 2022, the HSE told The Journal that appointments in its current screening round, where women were normally invited for screening once every two years, were “delayed by up to a year”.

This meant that if a woman was due to be screened in 2020, BreastCheck aimed to invite her in 2021; if she was due to be screened in 2021, BreastCheck will aim to invite her this year.

It said that during this time, Ireland would be “more in line with England, which screens women every three years”.

“However, we aim to return to screening women every two years as soon as possible.”

When The Journal asked the HSE this week if there was still a delay in appointment times, a spokesperson for the health service said: “Since 2022, we have been working to offer screening to as many women as possible, including women aged over 70 whose final screening test could not take place when screening was paused.

The 10 months of screening missed in 2020-2021 continues to have a significant impact on our ability to offer screening every two years.

Invite times are also affected by ongoing challenges in recruitment caused by a worldwide shortage of radiologists and radiographers,” the spokesperson said.

They said that high numbers of missed and cancelled appointments due ongoing Covid infection rates have also impacted on the number of women screened.

“The eligible population for BreastCheck is also growing year on year due to increases in the population aged 50 – 69, the eligible age range for BreastCheck.

“We are making every effort to return to two-yearly screening within the current operational constraints. We invite women for screening when we are screening in their area.”

The spokesperson said that any person who has concerns of symptoms concerning their breasts should not wait for an invitation to attend screening and should instead contact their GP who will give them the appropriate advice.