A REVIEW has begun to determine whether the State's national breast cancer screening programme should be extended to younger women.
The board of the National Cancer Screening Service (NCSS) decided at a meeting last week to commission an internal review of the evidence for screening women from the age of 47 years upwards.
At present BreastCheck is offered only to women in the 50-64 year age bracket but the chief executive of the NCSS, Tony O'Brien, said there was now "emerging and developing evidence" of the benefits of population-based screening for women below the age of 50 years. He said newer digital mammography was having an impact on this.
Women in the Canadian province of British Columbia have been offered breast cancer screening from the age of 40 upwards for up to two decades. And in the US the National Breast and Cervical Cancer Early Detection Program - which helps low-income, uninsured women gain access to early detection screening programmes - also offers breast cancer screening to women from 40 years up.
However, in the UK only women aged 50-70 years are screened. But the department of health there announced a year ago it was committed to extending the age range of women eligible for breast cancer screening from ages 47-73 over time.
Mr O'Brien said there wasn't really evidence that women from age 40 upwards should be offered regular breast cancer screening but the NCSS had commissioned an internal review of the evidence to inform its decision-making. He said he expected the review to be completed within a matter of months. He added that there was "very strong evidence" that the first priority should be to provide two-yearly screening to women aged 50-64 years.
There was also very strong evidence that the next priority should be to extend it to women aged 65-70 years, he said.
And referring to "emerging and developing evidence" of the benefits of population-based screening to women below the age of 50, he said this was now being examined.
Meanwhile, Mr O'Brien stressed it was very important women who developed any symptoms or concerns about their breast health, and who were outside the age criteria for the national breast cancer screening programme, see their GP who, if appropriate, would refer them onwards to symptomatic breast services.
The most recent national cancer strategy, published in 2006, recommended breast screening be extended to women up to 69 years old after the BreastCheck programme had been rolled out nationally. The Government agreed with the recommendation but gave no timeframe for extending the programme to the older age range.
BreastCheck began offering screening to women in the eastern region in 2000 and while the programme was then gradually extended across the State, women in some entire counties such as Kerry, Sligo, Leitrim and Donegal are still waiting to be invited for screening for the first time.
The Irish Cancer Society said it was not currently considered effective to offer systematic call and re-call breast cancer screening to women under 50 years because of the lower prevalence of breast cancer in women under 50 (75 per cent of all breast cancer cases are in women over the age of 50 years), the density of breast tissue in this pre-menopausal age group and the limits of mammography screening among in this age bracket.
"However, this may change with the implementation of digital mammography and as evidence emerges for lowering the age limit in other European countries," it said.
The Irish Cancer Society's Action Breast Cancer Helpline can be reached on 1800 30 90 40