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Breast And Cervical Cancer

Volume 951: debated on Tuesday 13 June 1978

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asked the Secretary of State for Social Services what progress he is making in providing a national screening service for breast and cervical cancer; what is the result of special studies commissioned by his department on these problems; and if he will make a statement.

For breast cancer, there is not yet sufficient evidence of its effectiveness and safety to justify the introduction of a national screening service. Further investigations, designed and controlled to give the maximum amount of information which could prepare the way for the progressive development of a national service if results warrant this, are being conducted.Screening trials of two types, both replicated and with controls, are being set up. They will take the form of, firstly, annual clinical examination over seven years with mammography every other year and, secondly, instruction in and encouragement to undertake regular self-examination with direct referral to clinics. The sites selected are Edinburgh and Guildford for the first type, and Huddersfield and Nottingham for the second. Each trial, based on a population of about 30,000 women aged 45–64 years, will be linked to a matched control district for comparison of breast cancer mortality over the ensuing 10 years. Evaluation of the long-term results should indicate the desirability and feasibility of providing a specific type of national service.For cervical cancer, a national cervical cytology screening service, aimed at the detection of pre-cancerous conditions of the uterine cervix, has been provided under the NHS since 1967, under the surveillance and advice of the Committee on Gynaecological Cytology. Facilities are provided by general practitioners, community health clinics, family planning clinics and hospital gynaecological departments. Special emphasis is placed on screening women at highest risk—that is, those aged 35 and over and younger women who have had three or more pregnancies, and women in this priority group whose test results are negative and invited to have a further test every five years. The service is expanding, and in 1976 over 2½ million tests were carried out in the United Kingdom.