§ Baroness Jegerasked Her Majesty's Government:
What is the National Health Service policy and programme for screening for cervical cancer; and what is their screening programme for breast cancer.
§ Lord TrefgarneThere is a well-established programme of cervical screening, which aims to reduce mortality from cervical cancer by regular screening of women at greatest risk. Present policy lays emphasis on the screening every five years of the priority group of women aged 35 and over and those who have been pregnant on three or more occasions.
The Committee on Gynaecological Cytology, who advise the Government on these matters, have recently reviewed this policy and reaffirmed the continuing emphasis on the screening of older women. Screening facilities are provided by general practitioners, family planning, ante-natal and other clinics. The screening programme is supported by arrangements for recalling women in the priority group. These are currently operated centrally by the NHS Central Register. The recall scheme has also been reviewed and found to be ineffective; we have therefore asked health authorities to provide alternative local arrangements by 1st April 1983.
The Government are spending £0.6 million a year on major trials designed to establish the efficacy of breast cancer screening. The trials involve a quarter of a million women between the ages of 45 and 65. They are designed to assess the practicability and efficacy of screening by mammography and clinical examination and to assess the feasibility of education in self-examination as an alternative method of early diagnosis. The trials of mammography and clinical examination are taking place in Guildford and Edinburgh: the self-examination trials in Huddersfield and Nottingham. Four centres have been established, in Avon, Dundee, Oxford and Stoke-on-Trent, to provide comparative information on unscreened populations. Studies of the psychological effects of early diagnosis programmes, of the radiation dose from mammography and of the costs of screening and education in self-examination are included in the research programme. The programme will continue until 1987 with follow-up of the study population until 1997. Preliminary results should begin to become available by 1986. The Government will consider the future development of breast cancer screening in the light of the results of the trials.