§ 3.24 p.m.
§ Lord Astor of Heverasked Her Majesty's Government:
Whether National Health Service breast screening techniques are sufficiently accurate.
§ Lord Hunt of Kings HeathMy Lords, no screening test can guarantee 100 per cent accuracy. However, mammography remains the most reliable way to detect breast cancer early.
§ Lord Astor of HeverMy Lords, does the Minister agree that, too often, harmless changes in breast tissue result in unnecessary removal, with all the associated risks of surgery? What progress is being made to improve the accuracy of screening by using computer technology to store and assess scans?
§ Lord Hunt of Kings HeathMy Lords, the noble Lord's suggestion is right in the sense that seven out of eight women who have an abnormal initial mammogram prove on further investigation not to have breast cancer. The initial test is only an indicator of whether further tests or surgery may be required. As to the use of computer-aided diagnosis, we recognise its potential but it is at an early stage. We are at present monitoring developments. I must tell the noble Lord that in introducing any new technology we must ensure that it is safe and effective.
§ Lord Clement-JonesMy Lords, in this context, in addition to the quality of screening, are not the resources devoted to diagnosis and treatment of breast cancer crucial? All the breast cancer charities still say that the resources allocated to them are not getting through. What is the Department of Health going to do about that?
§ Lord Hunt of Kings HeathMy Lords, it is fair to say that concerns about funding have been expressed by cancer charities. We are very much aware of that. On the evidence, we are considering the data on cancer investment in the routine returns we receive from the NHS. I must tell noble Lords that there are many omissions and inaccuracies in the current returns. Because of that, we have decided to undertake a special exercise in the NHS to compile investment on cancer to compare 2001–02 with 2002–03. We expect to be able to publish that information in the spring.
Despite those concerns, there has been a great expansion in the amount of equipment and number of consultants and radiographers employed in the service. That gives us confidence that the future development of cancer services appears satisfactory.
§ Baroness SharplesMy Lords, is consideration being given to extending the age group of women undergoing breast screening?
§ Lord Hunt of Kings HeathMy Lords, we are in the middle of extending screening programmes automatically to cover women aged 65 to 70. The aim is to complete that by 2004. So far, more than 150,000 more women have been invited for screening as a result of the extension. What evidence there is suggests that breast screening for women aged over 70 may not be effective and may even do more harm than good, 887 although there would be benefit for some individual women. Given that, women aged over 70 will be offered free yearly screening on request.
§ Earl HoweMy Lords, is the Minister aware that in some parts of the country, breast screening services have been suspended because of a shortage of radiologists? What is being done to tackle that shortage?
§ Lord Hunt of Kings HeathMy Lords, of course, if there is a shortage of staff—whether consultant radiologists or radiographers—that may impact on the screening programme. We are tackling the whole issue of workforce expansion. In fact, the number of consultants employed in cancer specialisms has increased considerably from just over 3,000 in 1997 to 3,860 in 2002. The number of diagnostic radiographers has increased from 10,360 in 1997 to 11,160 in 2001. We are also increasing the number of training places for future radiographers.