Breast Screening
Cervical Screening
Bowel Screening
Diabetic Retina Screening

Interval Cancer Expert Reference Group Reports

Implementation update - September 2021


The National Screening Service welcomed the publication by the HSE of the Expert Reference Groups' Interval Cancer Reports in October 2020 and is now working towards the implementation of the recommendations. The recommendations of the Expert Reference Groups provide a design for interval cancer review (patient-led and programmatic review) which supports quality assurance within each programme and which is in line with international best practice for cancer screening programmes.

To implement the recommendations of the ERG reports, a steering group and five working groups have been established. The groups are CervicalCheck; BreastCheck; BowelScreen; Legal Framework; and Communications.  The steering group communicates 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.

September update 

Our working groups continue to progress their specific implementation plans.  The CervicalCheck group is focused on the design of patient-requested reviews and disclosure processes. Four subgroups have been formed to further develop:

  1. An SOP for patient-requested review and disclosure processes 
  2. Resourcing of reviews and disclosure processes
  3. Patient information and supports
  4. Programmatic review

The BreastCheck group is finalising the review framework. This includes strengthening the processes for patient-requested review. Three established subgroups continue to focus on the review process, recruitment to the review process, and communication with patients and medical staff regarding the review process.

The BowelScreen group has developed a draft template for recording post colonoscopy colorectal cancer (PCCRC) from non National Cancer Registry of Ireland (NCRI) sources and updated BowelScreen’s IT system to ensure alignment to the agreed working definition of a PCCRC. This group continues to collaborate with the Communications group to develop patient information to enable informed choice and consent.

All above implementation groups continue to work closely with the NCRI / NSS Strategic Planning Group to progress the calculation of interval cancer rates.

The Legal Framework group is developing recommendations around the conduct of and participation in screening, based on current legal instruments, such that the benefits and limitations of screening are clearly defined and understood in the public, medical, legal and political sphere. Three pieces of research in the areas of law, health ethics and health economics have been commissioned to provide the evidence base to support the groups’ decision-making process in the development of recommendations.

The Communications Interval Cancer Implementation Group is undertaking qualitative and quantitative research to determine the attitudes and knowledge of the public towards screening.  Stage one of the research has been completed, which comprised of interviews with healthcare professionals engaged in the provision of screening services.  Stage two is under way and comprises a large-scale online questionnaire targeting 2,000 service users across all screening programmes.

We continue to plan a series of engagement exercises with the aim of enhancing the general understanding of cancer screening services, improving trust in HSE cancer screening services and ensuring resilience of our screening programmes into the future.


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