THERE HAS been a 50 per cent increase in the numbers of women referred to breast cancer centres over the past two years, many of them at low risk of disease, the director of the State’s cancer control programme has said.
Prof Tom Keane told the Oireachtas health committee yesterday that this huge change was “troubling” and not something which had been anticipated or planned for.
A way would have to be found for dealing with these extra numbers, many of them just worried about “vague symptoms of breast pain” or anxious about the possibility of having breast cancer. Some were as young as 19 or 20 years.
He said some of it reflected the huge concern there had been following the controversy around the misdiagnosis of a number of women with breast cancer.
He said the increase in referrals was putting “significant strain on the system” and was affecting all breast cancer centres except Galway.
Prof Keane said he may seek international advice on how to deal with these additional cases. It may be that a different pathway will be found for them and that they would just be referred for a mammogram. If this were the case the Hiqa breast cancer care standards would have to be changed, he said.
Fine Gael’s health spokesman Dr James Reilly told the committee he would not expose himself to legal action by not referring a patient to a symptomatic breast cancer centre if she had breast pain.
Meanwhile, Prof Keane estimates that 32,000 women will be seen by the eight breast cancer centres this year and of these 2,130 will be diagnosed with breast cancer.
It was envisaged that one in every 10 patients referred would be diagnosed with cancer. In some centres it was now one in 29. “Based on data for 2009 to date it is clear that there are two distinct groups of women being referred – cases classified as urgent which make up one third of the total referrals and routine referrals which make up the remaining two thirds.
“The risk of cancer detection is 10 times in the urgent compared to routine referrals.
“The risk of cancer in the routine referrals is similar to that for a breast screening population,” he said.
Prof Keane, who is due to finish his two-year term in Ireland next month, also said he will ask his Canadian employers to allow him to stay for a few extra months until his successor has been appointed.
He told the committee the transfer of breast cancer services from the South Infirmary Hospital in Cork to Cork University Hospital will go ahead next month. Then the goal will have been reached of having diagnosis and surgery on breast cancer patients at just eight hospitals.
He said as of last month 95 per cent of urgent referrals to these centres were being seen within two weeks as required by Hiqa standards. Some 85 per cent of non urgent cases were seen with 12 weeks, he added.
Prof Keane also said the board of the HSE recently decided cancer control would remain a separate unit within the HSE and this was “incredibly important”.
He agreed with committee members that there needed to be the same level of oversight of cancer care in private hospitals as in public hospitals.
He understood this would be addressed by legislation next year around the licensing of private healthcare facilities.
He confirmed the filling of new posts for the cancer control programme was exempt from the moratorium on recruitment but said replacements for people going on maternity or sick leave or leaving the service were not exempted.
Labour’s health spokeswoman Jan O’Sullivan said this needed to be addressed. Prof Keane agreed.