NEW INTERNATIONAL research raises questions about the direct contribution of screening for breast cancer to the fall in the number of deaths in the Republic and Northern Ireland.
While the benefits of screening and early detection are constantly stressed, the research shows that improved medical treatment and access to such care made a greater contribution than the screening programme.
From 1989 to 2006, deaths from breast cancer decreased by 29 per cent in Northern Ireland and by 26 per cent in the Republic of Ireland.
Breastcheck, the cancer screening programme in the Republic, only achieved full national coverage in 2009.
In contrast, screening began in Northern Ireland in the early 1990s.
The results of the analysis, published today in the British Medical Journal, suggest that despite the more than 15-year time difference in implementing a full screening programme in the Republic compared with the North, deaths from breast cancer declined at a similar rate in the Republic to Northern Ireland, where nationwide screening for the disease was well established.
Researchers from France, Northern Ireland and Norway compared trends in breast cancer mortality within three pairs of European countries – Northern Ireland versus Republic of Ireland, the Netherlands versus Belgium and Flanders, and Sweden versus Norway.
The researchers expected that a reduction in breast cancer mortality would appear earlier in countries with earlier implementation of screening.
Countries in each pairing had similar healthcare services and levels of risk factors for breast cancer mortality, but were different in that mammography screening was implemented about 10 to 15 years later in the second country of each pair.
The results show that from 1989 to 2006, deaths from breast cancer fell by 29 per cent in Northern Ireland and 26 per cent in the Republic of Ireland; by 25 per cent in the Netherlands and 25 per cent in Flanders (Belgium); and by 16 per cent in Sweden and 24 per cent in Norway.
In Belgium, Norway and the Republic of Ireland, mortality rates started to decrease years before most women in the target age groups attended screening, according to the study.
“The contrast between the time differences in implementation of mammography screening and the similarity in reductions in mortality between the country pairs suggest that screening did not play a direct part in the reductions in breast cancer mortality,” the authors say.
They conclude that better treatment and improving health systems are more likely to have led to falling numbers of deaths from breast cancer.
Breastcheck facts
WOMEN AGED between 50 and 64 are invited for screening every two years in the Republic, while those aged 50 to 70 are screened every three years in the North.
BreastCheck screened 121,160 women in 2009 and 845 breast cancers were detected, giving a rate of seven cancers for every 1,000 women screened.
There are four screening units in the Republic, supplemented by mobile units from each fixed location.