Breast Screening
Cervical Screening
Bowel Screening
Diabetic Retina Screening

Interval Cancer Expert Reference Group Reports

Implementation update May 2021


The Expert Reference Group (ERG) Reports on Interval Cancers in the BreastCheck, CervicalCheck and BowelScreen screened populations give recommendations and guidance for the future management of interval cancers in Ireland. These reports were commissioned as part of the Scally Review in 2018.  The reports focus on the need to design interval cancer reviews (patient-requested and programmatic review) which support quality assurance within each programme and which are in line with international best practice.

To implement the recommendations of the ERG reports, a steering group and five subgroups have been established. The subgroups are CervicalCheck; BreastCheck; BowelScreen; Legal Framework; and Communications.  The steering group communicate progress to the NSS Quality, Safety and Risk Management (QSRM) Committee and HSE management.

Membership of our groups is diverse, including representatives from patient and public advocacy groups, primary care, cancer screening experts, public health, legal experts, communication specialists, medical ethics and health economics.

May 2021 update

  • We are creating a series of engagement exercises which will be key to informing the implementation process, enhancing understanding, and improving trust in our screening services.
  • Our CervicalCheck, BreastCheck and BowelScreen subgroups are continuing to develop their project implementation plans, as follows:
    - The CervicalCheck subgroup is reviewing the international evidence of interval cancer reviews gleaned from the ERG survey findings.
    - The BowelScreen subgroup has agreed a working definition of a post colonoscopy colorectal cancer.
    - The BreastCheck subgroup is developing a framework for the implementation of recommendations.

The programme subgroups are working closely with the National Cancer Registry of Ireland (NCRI) and the NSS Strategic Planning Group. They are reaching out to screening communities internationally to achieve agreement on the definition of an interval cancer. Reaching this international consensus is the first step for us to be able to calculate, compare and benchmark our interval cancer rates.

  • The Legal Framework subgroup has been established and is chaired by Prof David Keegan. The group has representatives from the Department of Health, health ethics, public health, NSS clinicians, patient advocacy, legal, and health economics. This group is looking at the wider environment in which screening operates.
  • The Communications Subgroup is designing a large-scale behaviour and attitudes survey to create a "before and after snapshot" of public feeling and approach to screening. The aim of the survey is to provide a benchmark for wider NSS work on increasing trust in, and understanding of, screening. Review of the consent processes of each of the screening programmes is under way.


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