Annual Report 2005/2006: Director's Report
- Breast screening service provided to 59,960 women in 2005 - highest number of women screened to date. Programme Statistics for 2005 show that BreastCheck's performance, measured against the standards set in our Women's Charter, are consistently high. Significant progress made with extension of BreastCheck to Southern and Western areas.
The overall rate of acceptance of invitation to the screening programme of eligible women of 76.6% remains relatively consistent and is in excess of the target of 70%. During 2005 the number of cancers diagnosed was 318, resulting in a cancer detection rate of 5.3 cancers per 1,000 women screened, as compared to 6.1 in 2004 and 7.2 in 2003.
BreastCheck, The National Breast Screening Programme,maintained a high volume of screening activity in 2005 with 79,262 women invited for screening and 59,960 women attending. This compares to 68,046 invited and 50,540 screened during the previous year.
An increased proportion of women attending for screening were invited for subsequent screening (45,591 in 2005 compared to 33,051 in 2004). This resulted, as expected, in a lower number of cancers detected. Once screened, performance figures show that almost nine out of every ten women take up a subsequent invitation for screening. This has been a recurring feature of the programme since subsequent screening began in 2002.
In 2005 the uptake rate for eligible initial women (women invited to BreastCheck
for the first time) was 72.2% and represents an increase on last year’s
figure. Previous non-attenders (PNAs) are those women who failed to respond
to an invitation to attend a first screening appointment in a previous round.
These women continue to receive invitations to attend screening and are
the least likely group to attend their screening appointment. In 2005 over
a quarter of
PNAs invited actually availed of their screening appointment. Again throughout
2006 and 2007 it will be vital that our advertising, communications and
health promotion work focuses on this audience.
A full and detailed analysis of the Programme statistics is provided on
pages 11 to 19 of this report.
Overall 2005 was characterised by:
- The highest number of women screened to date
- A solid performance measured against clinical quality assurance performance parameters
- BreastCheck’s consistently high performance against Women’s Charter parameters
- Extension of the service to women in Carlow and Kilkenny
- Progress made towards national expansion of the Programme.
PACS and Digital Mammography Project
In 2005 digital mammography imaging and a PACS (Picture Archiving and Communications
System) were installed for evaluation in BreastCheck’s existing clinical
screening units – the Eccles Screening Unit adjacent to the Mater
Misericordiae University Hospital and the Merrion Screening Unit adjacent
to St.Vincent’s University Hospital, Dublin.
The technology allows mammograms to be acquired directly in digital form without the requirement for xray film and film processing as used in conventional mammography. PACS refers to the part of the system responsible for managing and storing the clinical image data and for presenting the images to the radiologists for reporting.
Our ongoing evaluation of the technology has highlighted the prospective
benefits of digital imaging in breast screening, including improved image
quality and consistency,more efficient workflow and administration,
client acceptance and satisfaction and the potential for reduced radiation
dose. Additionally, significant work has taken place and continues with
regard to the integration and interface with BreastCheck’s existing
information systems which is essential to achieve the most efficient use
of the system and to ensure the optimum levels of data quality.
Later in 2006 a mobile digital mammography unit will be added to BreastCheck’s
existing fleet of six mobile screening units. The use of digital imaging
in a mobile setting should benefit image quality assurance and
may offer greater flexibility in the deployment of mobile screening units.
As part of the national expansion of BreastCheck into Southern and Western areas, digital imaging technology will be used from the beginning. Following installation of this state-of-the-art digital imaging technology, the BreastCheck programme is likely to be the first screening programme internationally to be entirely converted to digital mammography.
National Expansion
Since the Minster for Health and Children, Mary Harney TD, gave her approval
for the a25m capital expansion project to the Southern and Western areas,
significant progress has been made to achieve the earliest possible commencement
of screening. Construction is progressing for the two new BreastCheck Clinical
Units based at the South Infirmary Victoria University Hospital in Cork
and University College Hospital, Galway. The project also
includes a new a3m symptomatic breast facility in Galway. Since appointment,
the selected design team has worked on the project, and planning approval
has been received in respect of both facilities. A contractor has been appointed
and the 48-week construction period will commence in autumn 2006. Clinical
Directors Designate have been appointed – Dr.Alissa Connors in the
Southern area and Dr.Aideen Larke in the Western area – and will commence
employment in November 2006. The process of advertising and appointing multidisciplinary
team members is underway and recruitment of lead Consultant General Surgeons,
Consultant Radiologists, Consultant Histopathologists, other clinical roles
and administrative staff has begun. As part of BreastCheck’s Human
Resources strategy, a major recruitment drive is underway in Ireland, the
UK and internationally to ensure a maximum number of staff to fulfil the
national expansion requirements.The construction of screening units and
ongoing recruitment will continue in parallel until screening commences.
Age Range Extension
The Department of Health and Children requested the Board to examine the
benefits and impact of extending the breast screening service beyond the
current 50-64 year age range.The Board has agreed to extend the BreastCheck
screening programme to the upper age limit of 69 years following the roll
out of BreastCheck nationally.
National Cancer Control Strategy
BreastCheck contributed to the Department of Health and Children’s
Cancer Control Strategy 2006. This strategy sets out recommendations regarding
the screening, detection, treatment and management of cancer in Ireland
in coming years. At the launch of the Strategy in June 2006, The Minister
for Health and Children,Mary Harney TD announced her intention to bring
BreastCheck and the pilot Cervical Screening Programme together under one
entity – The National Cancer Screening Service.The existing membership
of the National Breast Screening Board will be expanded to reflect this
increased remit, which also extends to examining the possible implementation
of a
Colorectal Screening Programme. BreastCheck is a successful and established
screening programme with a well developed business and governance model.
It is a logical development for this model to be extended to other screening
domains. I look forward to this evolution with confidence that it will be
an effective and efficient way to organise cancer screening in Ireland.
Conclusion
I am very pleased that we have increased the numbers of women availing of
the invitation to screening in 2005 by over 9,400 in 2005 compared to the
previous year. Additionally, in keeping with the national expansion of the
Programme, women in Carlow became included in the Programme from April 2005,
followed by women in Kilkenny from May 2006. As Director of the Programme
I am committed to the ongoing delivery of the service and to bringing BreastCheck
to women in the South and West of the country as soon as possible. At present
we remain on target to roll out at the end of 2007. I would like to sincerely
thank the Chairperson, the Board of the National Breast Screening Programme,
the Clinical Directors Dr.Ann O’Doherty at the Merrion Screening Unit
and Dr. Fidelma Flanagan at the Eccles Screening Unit,Majella Byrne, Chief
Operations Officer, the management team, clinicians and staff across all
disciplines of BreastCheck for their continued commitment to delivering
an excellent service in our current screening areas and enthusiasm and determination
to deliver the national expansion plan.
I wish to pay tribute to board member Professor Peter Dervan who will retire
from the Board this year.He has been a member of the Board since the establishment
of BreastCheck and has made an enormous contribution
to the programme.
Finally, I wish to acknowledge the hard work of our colleagues at the Cancer
Policy Unit and the Hospital Planning Office of the Department of Health
and Children.
Tony O’Brien
Director
November 2006
(from the Annual Report 2005/2006)
BreastCheck Programme Statistics 2005
Download full Annual Report 2005/2006:
English (.pdf file 640 kb, 38 pages - A4 format) BC-areport05-English.pdf
Irish (.pdf file 640 kb, 38 pages - A4 format) BC-areport05-Irish.pdf