Dail Éireann · 2024-05-02
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The national cancer strategy provides recommendations concerning the monitoring, testing and provision of comprehensive care to people who have an inherited predisposition to cancer, and the national cancer control programme, NCCP, leads on the development of services for this potential patient cohort. The national cancer strategy was launched in 2017. The service line is essentially a subset of the national cancer strategy, so any funding we get will be in the context of funding through next year for the national cancer strategy.
Specifically on those services for patients with a predisposition to cancer, we have direct ordering of BRCA testing, which was introduced in 2017 for ovarian cancer patients. It was expanded to breast cancer patients in 2021 and to prostate cancer patients in 2023. The first was homologous recombination deficiency testing for treatment of ovarian cancer.
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Deputy Stanton asked me to take this question for him. He is concerned that genetic variants are responsible for between 5% and 10% of cancers. He is concerned about whether we have an adequate funding model and about the waiting lists for this genetic testing because effective screening reduces healthcare substantially in the longer term.
The national cancer strategy provides recommendations concerning the monitoring, testing and provision of comprehensive care to people who have an inherited predisposition to cancer, and the national cancer control programme, NCCP, leads on the development of services for this potential patient cohort. The national cancer control programme hereditary model of care was published last August. I recognise that Deputy Stanton has been advocating on this issue for some time. That is a very important step forward. The national cancer strategy was launched in 2017. It has taken time to get to the hereditary model of care but it has now been published. It is a plan for the further development of services for people who have a predisposition to cancer. A steering group is in place, which is chaired by the director of the NCCP and includes patient representatives. Under this model, specialist cancer services will work as part of a national genetic service. This is being supported by an investment of nearly €5 million in the national genetics and genomic strategy, which was launched a little over a year ago, and an additional 18 posts. We are very aware of this issue. The hereditary cancer model of care is going to help with that. I know there are people who might want to be tested for the BRCA gene. Testing and identification can be life-changing and life-saving, so this is certainly an area on which we are progressing.
Deputy Stanton is very concerned about the current waiting lists. The Irish Cancer Society reports waiting lists of up to two years for testing. There is then potentially a further two years waiting for the risk-reducing procedure that the test may have signalled. Is the Minister monitoring waiting times? Will the new initiative involve a multi-annual plan for staffing and investment so that this programme is not competing with other urgent care that might squeeze it out?
The service line is essentially a subset of the national cancer strategy, so any funding we get will be in the context of funding through next year for the national cancer strategy. There is also a separate funding line for the genetics and genomic strategy, which is fairly recent. Specifically on those services for patients with a predisposition to cancer, we have direct ordering of BRCA testing, which was introduced in 2017 for ovarian cancer patients. It was expanded to breast cancer patients in 2021 and to prostate cancer patients in 2023. Last year, some 700 patients were tested, so there has been a very encouraging expansion of the service. I do not have the figures, but we are looking at the time it is taking. Some affected families have told me that they want to see the waiting time greatly reduced.
I ask the Minister to check those waiting times and report back to me and Deputy Stanton because the Irish Cancer Society is signalling quite long waiting times. For a screening test that can reduce long-term healthcare, it is to be hoped that it could be made more prompt.
I will ask the Department to revert to Deputies Bruton and Stanton. I want to mention good progress in two other areas. Two new types of testing were introduced last year for specific treatments. The first was homologous recombination deficiency testing for treatment of ovarian cancer. The second test is for NTRK gene fusions, which can lead to cancers of the brain, head, neck, thyroid, soft tissue, lung and colon. Also, the NCCP breast family history project is under way. This will streamline and standardise the service for asymptomatic individuals at elevated risk of developing breast cancer due to their family history. We are approaching it both in terms of the identification through family and also through gene testing. I will get back to the Deputies on the waiting times for BRCA testing.