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Published: 21 October 2020

Expert Reference Group Interval Cancer Reports

The National Screening Service (NSS) welcomes the publication of the Expert Reference Groups’ Interval Cancer Reports, and supports their recommendations. The NSS will work to implement those recommendations in full, in partnership with the people we care for, and our professional screening teams around the country.

The expert reports were commissioned as part of the Scally Review in 2018. They set out a new and comprehensive approach to reviews of interval cancers in people who have been screened by Ireland’s breast, bowel and cervical cancer screening programmes.

NSS Chief Executive Fiona Murphy said today: "An interval cancer is one that is diagnosed in a person who has been screened previously. While they are uncommon, they show how every screening programme has limitations, and cannot detect every case of cancer. The NSS welcomes the detailed work undertaken by the expert groups, and we commit to a careful, thorough and full implementation of each of the recommendations."

The expert reports acknowledge that Ireland's screening programmes operate to the best international standards and that they reduce deaths from cancer among people in Ireland. They affirm that world class screening programmes must balance patient trust, staff recruitment and affordability, and that interval cancers are an inherent feature of any screening programme. They emphasise the need to sustain our vital public health screening programmes.

The reports have set out a number of recommendations for the National Screening Service (NSS) and the Board of the Health Service Executive (HSE). Their recommendations will support the NSS in establishing an independent and safe system to support future management of interval cancers.

Dr Colm Henry, Chief Clinical Officer of the HSE said: "The HSE has now implemented more than 90% of Dr Scally's report and today marks an important milestone in that process. I want to thank both Prof Risteárd Ó Laoide and Prof Susan O’Reilly, and all those who worked on these reports. Their work will contribute to improving further our screening services, which make such a real and substantive contribution to reducing the incidence of cancer in the Irish people."

BreastCheck report chair Professor Risteárd Ó Laoide of the NCCP said: "Evidence from international accreditation, international expert opinion, and review of BreastCheck – the National Breast Screening Programme has confirmed that the breast screening programme in Ireland is operating to the best international standards. Breast screening reduces the number of deaths from breast cancer in Ireland by approximately 120 per year.

"The report has outlined a new strengthened, more robust model for the performance and disclosure of individual interval cancer case reviews, keeping the provision of information, patient choice and patient consent at the centre of the process."

CervicalCheck and BowelScreen reports chair Professor Susan O’Reilly said: "It has been my privilege to work with the professionals, patients, advocates and international experts who participated in this complex and sensitive project. I would like to thank all of them for their engagement in the development of the recommendations in our reports, which we are now pleased to publish."

Patient advocate review group member Bridget Doherty said: "I am happy that the NSS has undertaken to implement all of the reports' recommendations, and that the screening programmes are committed to working in partnership with patients as they make these important next steps."

Donal Buggy, Irish Cancer Society, Director of Services Delivery said: "These reports contain recommendations which will strengthen the BreastCheck, CervicalCheck and Bowel Screen services’ approach to the categorisation and reporting of interval cancers. The Irish Cancer Society looks forward to the full and early implementation of the recommendations."

Dr Gabriel Scally said: "I was impressed by the quality of the reports and pleased to note the public and patient representation on the working groups. I hope, for example, that the results of the international survey of cervical screening is published in the professional literature. I was pleased also to see the support for reform in the legal system being voiced, and changing the approach for all screening services would be a good place to start."

Fiona Murphy added: "I would like to thank all of those who contributed to the reports, including patient advocacy representatives, screening clinicians, international screening experts and research experts, as well as my NSS colleagues. I am confident that their work will enable us continue our successful drive to prevent cancer and save lives through population screening.

"We will update our websites with details of the implementation process, which will take some time as we work through a comprehensive transformation process to meet these new aims. People do not need to take any action. We will provide progress reports on implementation to anyone who registers with us on our information line, Freephone 1800 83 21 88, or by emailing info@screeningservice.ie. When our new processes have been designed we will get in touch with people affected."

The reports are attached below and published on hse.ie

For further information, email press@hse.ie