Breast Cancer Screening (Young Women)

Ian Lavery Excerpts

Tuesday 30th November 2010 Westminster Hall

[Pat Glass (North West Durham) (Lab)]

Breast Cancer is the UK’s most common cancer. It affects thousands of families every year. Almost 48,000 people were diagnosed with breast cancer last year: 47,000 women and 277 men, and 125 women will be diagnosed with breast cancer today. Breast cancer incidence rates among women have increased by 50% over the past 25 years—5% in the past 10 years—and, because of lifestyles changes such as increased obesity and drinking in young women, those incidence rates will continue to rise, particularly for those under 50. Eight in 10 breast cancers diagnosed are in women aged 50 or over, but that means that two in every 10 are diagnosed in younger women, who may have young families. For young women the disease can be particularly virulent and aggressive, and the chances of survival are less good as a result.

[Ian Lavery (Wansbeck) (Lab)]

Does my hon. Friend agree that the time between the mammogram and the results is critical, and that the length of that period depends on the area and district a person lives in and the hospital they attend? It could be between a week and up to four weeks, depending on the hospital, which could mean the difference between life and death. At the same time, those with money have the opportunity to have a mammogram in the morning and receive the results in the afternoon.

[Pat Glass]

That is incredibly true. I am particularly concerned about young women, and in many cases the younger they are, the more virulent the disease is and the chances of survival are less good as a result, so that is particularly crucial. Every family in this country will be touched by this awful disease. Within my family, four close relatives have died of breast cancer in recent years, all aged well under 50; and a cousin, also under 50, is currently battling the disease for a second time.

However, it was an inspirational woman, Trish Greensmith, who runs the Chyrelle Addams breast cancer appeal trust in my constituency, who first brought home to me the number of young women who are being diagnosed with, and having to fight, breast cancer today. She told me that when she first visited an oncology clinic she was struck by the number of young women in the waiting room—young women who were trying to deal with virulent and aggressive cancers while bringing up young families. Under the current system, they would never be offered the opportunity for routine screening, which might have detected their cancers early and saved their lives. More women are surviving breast cancer than ever before, and the survival rates have steadily improved over the past 30 years, but 12,000 women and 70 men in the UK died from breast cancer last year.

--- Later in debate ---

[Paul Burstow]

I am grateful to the hon. Lady for that clarification. In 2006, the Institute of Cancer Research published the results of a 15-year study of the benefits of screening women from the age of 40. The study invited about 53,000 women to receive annual breast cancer screening over nine years and then compared them to a control group of women who received standard NHS treatment. The study found that the reduction in deaths due to screening was not statistically significant. I understand that, for the individual, it is 100%; I understand the hon. Lady’s powerful point. She might say that, if such measures save a single life, they are worth doing. However, the study pointed out, as she seemed to guess, that early screening had significant disadvantages. Almost one in four women in the study had at least one false positive, with all the resulting distress, anxiety and unnecessary follow-up, including invasive biopsies. Currently, there are about 7 million women aged between 30 and 49 in England. I accept that she wants to screen from 35 onwards, but if the take-up rate among that population were 75%, we would be screening about 5 million more women a year. Even if the minimum age were 35, it would create the issue of false positives.

[Ian Lavery]

Does the Minister agree that there is still a huge diagnosis problem, involving the time between mammogram and results, based on what is classed as a postcode lottery? We need to look at that and ensure that each patient, regardless of wealth or where they reside, gets her mammogram results within days, not weeks.

[Paul Burstow]

Yes. It is entirely right for the hon. Gentleman to make that point. That is why this Government will publish the first ever NHS outcomes framework, which will focus much more clearly on how we ensure that the system delivers the right outcomes in terms of cancer survival. We will publish that shortly, along with a new cancer reform strategy in due course that will say even more.

The Government’s view at present is that the risks of the change proposed by the hon. Lady outweigh the benefits. However, I want to ensure that the evidence that she has discussed is properly evaluated by officials in the Department. We will consider those points and her representations carefully, and I will write to her after we have had an opportunity to do so. However, the Department’s view and the Government’s view about maintaining the status quo is shared by most countries in Europe, as well as the Council of Europe, which recommends a breast cancer screening age of 50 to 69. The United States recommends screening every two years for women aged between 50 and 74. The position that this country has adopted for a considerable time is based on international practice and the best available evidence. One must be open to changes in evidence; that is important in an evidence-based approach to developing policy.