Asked by: Helen Hayes (Labour - Dulwich and West Norwood)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether she is taking steps to provide support to the Lobular Breast Cancer Project.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Department invests £1.3 billion per year into health research, with more spent on cancer than any other disease group, through the National Institute for Health and Care Research (NIHR). We work closely with UK Research and Innovation (UKRI) and the Medical Research Council (MRC), who are responsible for channelling a large proportion of the Department for Science, Innovation and Technology’s investments in this area. Our officials meet regularly to discuss a wide range of our investments, including into lobular and other breast cancers, to drive the maximum collective research impact on policy, practice, and individual lives. While research to understand the mechanisms of cancer, including lobular breast cancer, is largely funded through UKRI and the MRC, the NIHR invests in translational and implementation research to drive innovations into policy and practice.
Launched in 2023, the Lobular Moonshot Project is a high-level funding proposal and campaign to raise money to support the Institute for Cancer Research (ICR), with whom we meet regularly, to invest in fellowships and projects in lobular breast cancer. We are proud to have invested £29 million in the ICR and Royal Marsden NIHR Biological Research Centre in 2022, supporting their efforts to strengthen research into cancer, again including lobular breast cancer. This is complemented by wider investments into breast cancer research, for example, a £1.3 million project to determine whether an abbreviated form of breast magnetic resonance imaging can detect breast cancers missed by screening through mammography, such as lobular breast cancer. Our support to the NIHR Clinical Research Network has enabled the delivery of 10 further lobular breast-cancer related studies.
Additionally, the NIHR supports breast cancer research funded by research partners in the charity and public sectors through the NIHR’s Clinical Research Network (CRN). Over the last five years, the CRN has supported delivery of 10 lobular breast cancer-related studies conducted by other partners. While the NIHR cannot respond to direct solicitations for funding, instead commissioning on the basis of research excellence, we would welcome more applications from researchers on lobular breast cancer, including from the ICR. The NIHR funds research on cancer prevention, detection, diagnosis, treatment, and care, which saves lives.
Asked by: Peter Gibson (Conservative - Darlington)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make an assessment of the potential merits of providing lymphaticovenous anastomosis surgery on the NHS.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
No formal assessment has been made of the potential merits of providing lymphaticovenous anastomosis surgery on the National Health Service. On 16 April 2024, the National Institute for Health and Care Excellence (NICE) published interventional procedures guidance that states that lymphovenous anastomosis during axillary dissection for preventing secondary lymphoedema in adults with breast cancer, can be used in the NHS while more evidence is generated, and that it can only be used with special arrangements for clinical governance, consent and audit, or research. The NICE’s interventional procedures guidance makes recommendations for the NHS on whether procedures are sufficiently safe and efficacious for use in routine clinical practice.
Asked by: Luke Evans (Conservative - Bosworth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to support women with a genetic history of breast cancer to access screening services in (a) England and (b) Leicestershire.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
In Leicestershire and nationwide, women with a very high risk (VHR) of breast cancer due to family history may be offered screening earlier and more often, as part of the NHS Breast Screening Programme.
Women formally identified as eligible for VHR breast screening are referred to the National Health Service breast screening service associated with their general practice. They are eligible to be screened from the age of 25 years old upwards, and should be invited every year. The diagnostic screen includes mammography or magnetic resonance imaging, depending on age and risk criteria, and is therefore not the same as the routine breast screening service. To support screening of VHR women, a new central database is planned to ensure all referrals reach NHS breast screening services.
Asked by: Craig Tracey (Conservative - North Warwickshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether her Department has made a recent assessment of the potential merits of using breast density assessment software at women's first breast cancer screening appointments; and if she will make an assessment of the potential impact of that technology on women's awareness of their personal risk of developing breast cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Breast Screening Risk Adaptive Imaging for Density trial is looking into the use of supplementary imaging techniques for women, within the standard breast screening programme, who are found to have radiographically dense breast tissue. The UK National Screening Committee, which advises ministers and the National Health Service in all four countries in the United Kingdom, will review this evidence when it becomes available.
Asked by: Caroline Lucas (Green Party - Brighton, Pavilion)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will make a comparative assessment of the adequacy of the reasons the (a) National Institute for Health and Care Excellence has been unable and (b) Scottish Medicines Consortium has been able to recommend Enhertu for use on the NHS.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) makes authoritative, evidence-based recommendations for the National Health Service in England on whether new licensed medicines should be routinely funded by the NHS, based on an assessment of their costs and benefits. Decisions on the availability of medicines in Scotland are a matter for the devolved administration.
The NICE published guidance in 2021 and 2023 recommending Enhertu, also known as trastuzumab deruxtecan, for the treatment of NHS patients with HER2-positive breast cancer through the Cancer Drugs Fund, and it is now available to eligible NHS patients in England in line with the NICE’s recommendations.
The NICE is currently evaluating Enhertu for the treatment of metastatic HER2-low breast cancer, and has not yet published final guidance. Stakeholders have had an opportunity to appeal against the NICE’s draft recommendations, and the NICE will consider any appeals through the established process and publish final guidance in due course.
Asked by: John Hayes (Conservative - South Holland and The Deepings)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether NICE is taking steps to make Enhertu available to the National Health Service to treat incurable HER2-low secondary breast cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is currently developing guidance for the National Health Service on whether Enhertu can be recommended for routine NHS funding, based on an assessment of the costs and benefits. The NICE was unfortunately unable to recommend Enhertu as a clinically and cost-effective use of NHS resources in its final draft guidance published on 5 March 2024. Stakeholders have had an opportunity to appeal against the NICE’s draft recommendations, and the NICE will consider any appeals through the established process, and will publish final guidance in due course.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what estimate she has made of the timeline for meeting cancer screening uptake targets for (a) breast, (b) cervical, (c) bowel and (d) prostate cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is committed to improving uptake in all screening programmes, including for breast, bowel, and cervical screening. There is no national screening programme for prostate cancer. The improvement in cancer screening programmes is not predicated on a specific timeline, but is focusing on targeting specific groups where uptake is low.
NHS England has developed a national improvement plan in collaboration with key stakeholders to improve uptake within the breast screening programme. This plan will encompass a series of evaluative projects, which are expected to report in April 2024
A range of improvements and innovations have been brought in to help improve uptake in the NHS Cervical Screening Programme. For example, appointments are being made available during evenings and weekends, and in some areas cervical screening appointments can be made in any primary care setting, rather than just at one’s own general practice.
In addition, we are also working to test the effectiveness of human papillomavirus infection self-sampling as a primary cervical screening option, with individuals taking their own cervical screening sample. The findings from this evaluation will be used to inform a UK National Screening Committee recommendation, and it is expected that self-sampling could lead to an increase in uptake as it will reduce some of the barriers that prevent people from attending a screening.
Uptake in the NHS Bowel Cancer Screening Programme is currently above the achievable threshold of 60%, between 1 July and 30 September 2023 it was 67.4%, and therefore the focus for this screening programme is on gradually reducing the age of the eligible cohort from 60 years old down to 50 years old, to increase to numbers eligible for this programme.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to increase the uptake of screening for (a) breast, (b) cervical, (c) bowel and (d) prostate cancer.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is committed to improving uptake in all screening programmes, including for breast, bowel, and cervical screening. There is no national screening programme for prostate cancer. The improvement in cancer screening programmes is not predicated on a specific timeline, but is focusing on targeting specific groups where uptake is low.
NHS England has developed a national improvement plan in collaboration with key stakeholders to improve uptake within the breast screening programme. This plan will encompass a series of evaluative projects, which are expected to report in April 2024
A range of improvements and innovations have been brought in to help improve uptake in the NHS Cervical Screening Programme. For example, appointments are being made available during evenings and weekends, and in some areas cervical screening appointments can be made in any primary care setting, rather than just at one’s own general practice.
In addition, we are also working to test the effectiveness of human papillomavirus infection self-sampling as a primary cervical screening option, with individuals taking their own cervical screening sample. The findings from this evaluation will be used to inform a UK National Screening Committee recommendation, and it is expected that self-sampling could lead to an increase in uptake as it will reduce some of the barriers that prevent people from attending a screening.
Uptake in the NHS Bowel Cancer Screening Programme is currently above the achievable threshold of 60%, between 1 July and 30 September 2023 it was 67.4%, and therefore the focus for this screening programme is on gradually reducing the age of the eligible cohort from 60 years old down to 50 years old, to increase to numbers eligible for this programme.
Asked by: Jason McCartney (Conservative - Colne Valley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department plans to take to increase breast screening uptake; how much funding she plans to make available for the breast screening uptake improvement plan developed by NHS England; and what recent assessment her Department has made of the effectiveness of the breast screening programme.
Answered by Andrew Stephenson - Minister of State (Department of Health and Social Care)
The Government is committed to improving uptake in the NHS Breast Screening Programme (NHS BSP), and is working with NHS England on the development of the breast screening improvement plan.
At this time, NHS England has not requested any additional funding to support the delivery of the breast screening improvement plan. Assessment of the effectiveness of the NHS BSP is made through the regular accountability meetings, under the Public Health Functions Section 7A Agreement.
Asked by: Ronnie Cowan (Scottish National Party - Inverclyde)
Question to the Department for Science, Innovation & Technology:
To ask the Secretary of State for Science, Innovation and Technology, if her Department will meet with the Lobular Moon Shot Project to discuss lobular breast cancer research.
Answered by Andrew Griffith - Minister of State (Department for Science, Innovation and Technology)
I have recently met with the Lobular Moon Shoot Project to discuss how government can support lobular breast cancer research.