Breast Cancer Screening

Debate between Baroness Falkner of Margravine and Lord O'Shaughnessy

Thursday 3rd May 2018 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness asks an extremely good question. It is important in this instance to distinguish between the very correct questions that she is asking and the particular problem in this case. In this case the problem is not one of resource but of, unfortunately, an IT flaw in the interaction between the national screening programme database and its AgeX trial. I want to make that clear. But in response to her question, we had an opportunity to debate these issues in the House yesterday in an Oral Question from the noble Baroness, Lady Thornton. We are increasing and have increased the number of specialist cancer nurses, for example, by 1,000. Health Education England, in its cancer workforce strategy, has outlined a plan to recruit more radiologists, radiotherapists and so forth. Having more staff and higher-trained staff with the proper competency frameworks is clearly one way in which we can deal with the variations that she rightly highlights.

[Baroness Falkner of Margravine (LD)]

My Lords, the Minister mentioned that the Government will be looking at public information campaigns to ensure that women who may not have captured the periodic screening letter that is sent out would be aware that they need to take the initiative themselves and find out if they should have been screened. But, if I understood him correctly, when the Minister gave the figures in the Statement, 270 was the upper limit of deaths that would have been caused. If that is the case, I am slightly perturbed in terms of frightening people. He would probably accept that, whatever the figure, it is impossible to be precise about the number of deaths that “would” have been caused. Perhaps he meant to say “may” have been caused—because screening of itself does not cure breast cancer. That is an important distinction to make.

[Lord O'Shaughnessy]

The noble Baroness makes an incredibly important point. To refer back to the Statement, I think that the word used was “may” and that an upper range was given. I want to distinguish between two things. The first is the national campaigns that take place—I think there were 14 in the past eight years—to encourage women to check for their own symptoms and take up opportunities for screening programmes. Those will continue; that is part of the overall programme. In terms of writing to the women who are still alive who may have been affected, that is a separate and discrete process. It will start with a letter. It is easy for us to track down those who are registered with a GP in England and we are working with colleagues in the devolved Administrations, as noble Lords would expect, to make sure that we can write to those who have moved to those countries, and to provide resources to those countries so that they can provide screening. A helpline is also included that has been publicised.

On the point about the number of deaths that may have occurred, it is a difficult issue. On the one hand, we have received advice that that may be the case and we felt that it was wrong not to be honest and transparent about it. At the same time, there is not a clinical consensus about the benefits of breast cancer screening for women aged 70 and over—that came as something of a surprise to me—because of the non-malignancy or low malignancy of some tumours that can be spotted and the harms that can follow from treatment.

So we need to be cautious. What we have projected as a range is based on statistical modelling and not based on scrutiny of actual case note reviews. Of course, we deeply hope that the number will come down as we carry out that inquiry.