Cancer centres under pressure as referrals soar
Prof Keane said there has been a 50% increase in the number of new cases referred to the centres’ symptomatic breast service over the past two years but the number of new cancer cases only increased slightly, reflecting the significant change in referrals.
He told the members of the Oireachtas Committee on Health and Children there had been a huge increase in the number of GPs who were referring women who did not have breast lumps but had breast pain and were worried about breast cancer.
He estimated that about 32,000 women would be seen this year with about 2,130 cases diagnosed.
“The number of new cancer cases, however, is only slightly increasing and reflects the significant change in the population of women being referred.”
Cases classified as urgent made up one third of the total referrals with routine referring making up the remaining two-thirds. The risk of cancer detection is 10 times greater in the urgent category.
During the month of September, 95% of urgent cases were seen within the two week standard and 85% at lower risk within the 12 week standard.
Prof Keane said many of the women complaining of breast pain were aged between 20 and 35 and some of the most extreme cases were being referred back to the GPs.
He said in a bid to free up clinics, having some women referred directly for a mammogram was now being considered.
“Being breast aware is good but it is not appropriate for a 22-year-old woman to have an annual mammogram. It is actually dangerous.”
Fine Gael’s health spokesman, Dr James Reilly, said he had a case where a woman did not have a discernible lump but was experiencing breast pain. He referred her to a clinic and it transpired that she did have breast cancer.
Dr Reilly said he would not expose himself to being sued for not seeking a mammogram for a patient and believed there should be a direct route to mammography for women who are concerned about ongoing breast pain.
Prof Keane said that good GPs only referred women that they were concerned about but that did not occur across the board. “We have some GPs who refer women with any breast symptom.”
Chief executive of the National Cancer Screening Service, Tony O’Brien, said around 10,000 women who had contacted CervicalCheck during September received invitation letters for a free smear test that they could present to participating GPs.
Last year, women within the 25 to 60 age group were encouraged to make their own appointments without restrictions and there were fears expressed by the Irish College of General Practitioners that the introduction of an invitation letter could result in those “at risk” being refused a smear test.
Mr O’Brien said free screening was available to any woman who wanted it. “Any woman who has not had a smear test in three years and wants one now can request an invitation letter by logging onto www.cervicalcheck.ie or calling 1800 454555.”
