Gabriel Scally: Restart cancer screening where it left off

Gabriel Scally: Pausing breast and cervical screening was correct but restarting the service should be done as soon as possible. Picture: Sam Boal/RollingNews.ie

Breast and cervical smear screening programmes must resume at the point where they were paused due to Covid-19, public health expert, Dr Gabriel Scally, has urged.

Dr Scally said the correct way would be to start the programmes where they left off so that women who had been due to be screened over the last couple of months are not missed.

The author of the report into the CervicalCheck controversy said the decision to pause the screening was correct but that services must be restarted as soon as possible.

He said programmes that involve intimate examinations could not continue during the public health emergency because of the need for social distancing.

Dr Scally was particularly concerned about women needing regular smears and mammograms because of concerns about potential disease. They had to be a "first priority" when services resumed, he stressed.

However, he did not think it would be easy to clear the backlog that had built up because the services would have to double the numbers and that was not possible.

He expected there would be a delay of months for cervical smears and, while that was not ideal, because the screening test was scheduled every three years it did not present an enormous difficulty.

I am much more concerned about women who are developing symptoms at the present time who are going to need to be seen and they should be encouraged to come in as soon as possible when those services reopen.

The Irish Cancer Society urged the HSE to publish a plan outlining how all available capacity in the public and private sector would be used to deal with the backlog in an efficient way.

“The decision to pause screening service was made in line with public health advice but as work begins to restart our health system we must now see a detailed roadmap for the safe return of screening programmes,” it said.

The ICS said the programmes were initially paused to reduce the number of healthy people attending medical environments at the beginning of the Covid-19 pandemic.

“It is now essential that screening is safely returned to full capacity as soon as possible and the backlog is dealt with promptly and safely,” it said.

The Marie Keating Foundation said it wanted clarity on when the services could resume safely, the available capacity, and what prioritisation would be given to those who may have had screening or follow-up testing delayed.

The two cancer charities urged anyone with cancer symptoms or concerns to see their GP without delay.

Update: HSE says plans plans are being made to restart screening programmes

Plans are being made to restart national screening programmes that were "paused" in March to protect patients and staff, according to the HSE.

It says staff were temporarily redeloyed to symptomatic services where possible, with some staff moved to support the response to Covid-19.

The national screening service is making plans for recommencing the four programmes - BreastCheck, BowelScreen, CervicalCheck and Diabetic RetinaScreen.

However, the restarting of screening will be based on HSE and Department of Health guidance on Covid-19 as measures to prevent Covid-19 are amended by the Government.

The HSE says BreastCheck's static units continue to operate daily clinics for the large number of women of every age who are presenting at hospital with symptoms of breast cancer.

BreastCheck is helping hospitals work through those waiting lists of women with symptoms who have not yet been seen due to the public health emergency.

"We are prioritising these urgent/high-risk cases," says the HSE.

BowelScreen is dentifying patients referred for surgery and/or surgical opinion. Each patient is being contacted to offer support and a programme contact number.

CervicalCheck has paused sending invitations and reminder letters for cervical screening.

"The pause is for community testing (GPs and clinics) and not for patients already referred to or in the process of being managed within the colposcopy system," the HSE says.

"These patients will continue to be cared for as hospital resources allows. Colposcopy units are prioritising their work in line with clinical need and staffing availability."

The HSE is urging people who are inbetween screening appointments, or waiting reschedled appointments to be aware of and act on any symptoms associated with the conditions being screened for.

Anyone with concerns should contact their GP immediately.