On Wednesday the health secretary, Jeremy Hunt, announced that an estimated 450,000 women in England were not invited to their final breast-screening mammogram, between the ages of 68 and 71, as a result of an IT failure dating back to 2009.
The shocking scale of the problem has raised a number of questions; not just how it came about, but also how it took nine years to be identified. The immediate focus must be on urgently rectifying the situation for the women involved.
Women over the age of 70 who have been subsequently diagnosed with a more advanced breast cancer during that period will wonder if it might have been picked up earlier, or required less aggressive treatment, had they undergone the final mammogram screening.
It is especially harrowing for those who have lost a wife, mother or sister to breast cancer over the last nine years, and cannot help but wonder if it could be related to their being part of this cohort of women. Facing difficult cancer treatment or mourning the death of a loved one is hard enough, but the thought that this could have been avoided will make it worse.
The first priority is to identify the more than 300,000 women estimated to still be alive, and get in touch with them to offer a mammogram now if appropriate. Women aged under 72 years will automatically be offered a mammogram appointment, while older women will be asked to phone a contact number to discuss the possible benefits of having a mammogram. This is important: some of the women affected will be almost 80 years old and, depending on their general health, there is a risk they could undergo treatment for lesions that would be so slow-growing they would never have caused any problems. Even tracking everyone down will be a major undertaking, to ensure, as the secretary of state promised, that all the women affected receive a letter by the end of May.
Hunt said no such problem had been identified in the breast-screening services of Wales or Northern Ireland, although they use a similar IT system, while Scotland uses a totally different IT system. However, the devolved nations will have to help NHS England identify women who may have subsequently moved from England in their late 60s or early 70s, and arrange to offer them mammograms at their local screening unit.
Hunt has promised that all catch-up mammograms will be carried out within the next six months, but carrying out thousands of extra mammograms will put further strain on breast-screening services stretched by a significant shortage of radiographers and radiologists. While he has promised extra, it will be challenging to avoid impacting the regular screening service for women aged 50-70. Extra sessions may have to be carried out in evenings or weekends.
I welcome the fact that there will be an independent review to find out what actually went wrong and why it was not spotted for so long. Early detection of any cancer provides the best chance of a positive outcome so it is important that this failure to recall women for their final mammogram does not put others off from taking up their normal screening invite.
Scottish Government Health Secretary Shona Robison said:
"I want to reassure members of the public that this issue does not affect the NHS in Scotland and patients should be reassured that there are no problems with our breast screening programme records or IT systems.
As usual, all women should continue to be aware of changes to their breasts and if they have any concerns they should see their GP. Scottish Government officials will be working with Public Health England to identify any women affected in England who have subsequently moved to Scotland."
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