THE PUBLIC IS invited to submit ideas on other diseases or conditions for which the Irish population should be screened by the state, with the chair of the Government’s Population Screening Advisory Group predicting that the pandemic will likely have increased interest in public health measures.
The National Screening Advisory Committee, which advises the health minister on population screening proposals, called people this week for their ideas – but its chairman said “basic criteria” must be met for that a proposal be taken into account.
The National Screening Advisory Committee (NSAC) was created two years ago in response to the CervicalCheck controversy and is made up of 18 independent experts, primarily in the health field.
In his 2020 annual report, the chair of the screening committee, Professor Niall O’Higgins, wrote that “public confidence in cancer screening needs to be improved,” and that this was a “goal important ”for the NSAC.
Talk to The newspaper, O’Higgins said it can be difficult to convey the benefits of preventative health measures like vaccines and screening – but also said he believed there was an increased interest in personal health that may spark new interest in screening.
There is, however, a high bar for a new screening program for the general population.
For example: the condition sought must be a significant public health problem; the disease must be preventable or can be identified as a very early stage when the prospects for recovery are very high; there must be an understanding of how the disease progresses; and there must be a suitable and acceptable test for it.
There must also be acceptable treatment, a policy regarding who to be treated and facilities for treatment; and a measure of the cost of screening versus the cost of the health system as a whole.
It also needs to be an “ongoing process,” says O’Higgins: “Screening is not just a kind of ‘once and for all’ event, it needs to be changed in light of new developments and developments. scientific discoveries. “
There are also downsides to screening that need to be explained and discussed.
“A drug test can lead to an unnecessary drop in a lot of anxiety in people,” says O’Higgins.
“For example, if there is a test that is positive, but when it comes to the final diagnosis of the disease, and it may be a false positive test, then you are putting people through a lot of unnecessary anxiety. This is a fairly significant drawback of screening.
But public participation allows this debate and this explanation to continue so that people know the downsides as well as the huge benefits in terms of the survival benefit.
Call for suggestions
The National Advisory Committee on Screening (NSAC) this week asked members of the public and groups of healthcare professionals to submit their ideas on new population-based screening programs to be implemented or how those that already exist should be improved.
Screening means people look for conditions they don’t know they have – unlike people who have symptoms or complaints – they go to the doctor.
“But when screening, the state (in this case) goes out to the public and says we have a test that can prevent serious illness, or improve cure rates, or reduce premature death, or maintain better. quality of life.
Population-based screening – it’s not just for one, it’s for many.
A similar selection committee in the UK is appealing to the public for suggestions.
We want the public to be an active participant because we see screening as something that belongs to the public.
Ireland already has five testing services in Ireland:
The NSAC was developed in response to the CervicalCheck controversy in 2019, which arose after more than 221 women diagnosed with cervical cancer found that their previous smear tests had been audited by the CervicalCheck program, and estimated that ‘a different action could have been taken while reading. their smears.
They were not made aware of this information until years later. In some cases, GPs and women’s doctors withheld the audit result until the controversy was first made public.
Although the CervicalCheck program has undergone a series of changes, as recommended by the Scally report in 2019, and a panel of UK experts found that it has broadly the same margin of clinical error as others in the world. Internationally, public health officials are concerned about the level of mistrust that remains in the program.
From 2015 to 2017, there were 264 cases per year of cervical cancer in Ireland. Of this number, approximately 160 women per year are diagnosed through the CervicalCheck program (approximately 60% of all diagnoses).
Each year in Ireland, 90 women die from cervical cancer. Without a national cervical smear program, the numbers could double: 320 women could be diagnosed and 180 women could die.
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When asked if they were waiting for suggestions for the CervicalCheck program, O’Higgins said it was not the committee’s role to make suggestions, but simply to advise the minister on new proposals or new ones. suggestions for existing programs.
In a way, I have a personal feeling that the Covid pandemic, out of necessity, has drawn people’s attention to their own personal health in ways that were not expected or anticipated, and which may raises interest in new screening programs.
“There is a high likelihood that public awareness of their health and screening will be heightened in the wake of the pandemic,” O’Higgins said.
The call is open for public input from November 1 to December 23, and there will be more calls in the years to come.
You can submit suggestions at gov.ie/screeningcall.