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Well-monitored national breast screening service

BreastScreen Aotearoa, developing into a coherent well-monitored national service, says independent report

An independent report on BreastScreen Aotearoa (BSA), released on Friday, commends the quality systems in place to ensure the national breast screening programme provides the maximum benefit to New Zealand women.

The report follows a review carried out by British cancer screening expert Professor Jocelyn Chamberlain of the South West Wales Cancer Institute, to assess any implications for the programme following last year's release of the Ministerial Inquiry Report into Cervical Screening Abnormalities in Gisborne.

In the Report's summary Professor Chamberlain says "the quality of the [programme's] screening process is high and it is provided in a consistent way across all Lead Providers that is likely to maximise the benefit and minimise the harm."

"The systems in place to safeguard against poor performance are comprehensive, and, although it is never possible to guarantee 100% 'safety', the danger of an incident comparable to earlier screening failures in New Zealand is remote," Professor Chamberlain says.

Professor Chamberlain also notes that "most of the recommendations of the Gisborne Inquiry Report which apply in modified form to BSA have already been implemented."

Deputy Director-General Public Health Don Matheson welcomed the report. "Professor Chamberlain's report is a comprehensive assessment of the programme that followed a very thorough process of meetings between Professor Chamberlain and many key people involved in breast screening in New Zealand," he says.

"The Report's 22 recommendations cover a range of operational issues and provide the type of peer review that is invaluable at this point of the Programme's development.

"Most of the recommendations provide advice on operational aspects of the programme while others suggest further policy development. We intend to consider the Report's recommendations and work with the programme providers on addressing the issues raised. This work has already begun," Dr Matheson says.

"One of the Report's recommendations suggests consideration be given to the establishment of a seventh Lead Provider to relieve the very large workload in the BreastScreen Auckland and North region, which Professor Chamberlain notes is larger than any of the UK's 95 regional screening programmes.

"The National Screening Unit will work with BreastScreen Auckland and North, DHBs and other local service providers to review the provision of services in this region and identify options to address issues related to the screening workload. The outcome of this work should be available within the next six months," Dr Matheson says.

"The NSU has also been working closely with BreastScreen Auckland and North to address recruitment issues in the region as part of the work to increase the number of women accessing this free service."

The Report finds that the principal constraint for the programme is the lack of a national population-based register. "The Ministry's Population Register Project is being led by the Ministry of Health's New Zealand Health Information Service and it is anticipated that the first stage of its development will be completed by mid-2003."

BreastScreen Aotearoa was established in December 1998 and is now in its fourth year. In the last 24 months to June 2002 176,165 women were screened in the programme, which is 58.4% of the eligible population. During the same period BreastScreen Aotearoa detected 1184 cancers.

"The success of the programme can be attributed to the commitment and dedication of all the people who work in the programme," Dr Matheson says.

The review of BreastScreen Aotearoa took place in February and March 2002 and followed a recommendation by Professor David Skegg of the University of Otago that called for BreastScreen Aotearoa to be evaluated against the Ministerial Inquiry recommendations.

Copies of the report can also be found at:

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