Speakers - Annual Scientific Meeting
Fidelma L Flanagan
Prof. Flanagan helped set up the National Breast Cancer Screening Service in the Republic of Ireland and is the Clinical Director, Eccles Unit, since 2000.
Her recent role as National Clinical Advisor to BreastCheck commenced in 2021. She was the inaugural QA Lead in BreastCheck and was involved in the publication of the first National QA Guidelines for BreastCheck. She has helped oversee three international accreditation reviews of BreastCheck.
Prof Flanagan is a strong advocate for QA in screening and has been actively involved in responding to recent controversies in Ireland around screening and Interval cancers. She is a member of the:
- Interval Cancer Steering Group
- Interval Cancer Implementation Group
- Legal Framework Group
- National QA committee
She has been involved in the publication of HSE commissioned reports on cancer screening in Ireland. She has published on Breast Cancer, Pet Imaging and Breast Cancer Screening.
Prof. Flanagan has organised numerous International Breast Cancer conferences in Dublin. She, herself, has presented and chaired at many conferences worldwide.
She enjoys and is actively involved in teaching at under and post graduate levels in the MMUH and in UCD
Title: The Ripple Effect - How controversy in one screening program affected another.
CervicalCheck conducted an audit of cytology in all women who developed invasive cervical cancer in the first eight years of the program. Issues arose in 2018 in relation to inconsistent disclosure of the audit results to patients.
The subsequent Scoping Inquiry into the CervicalCheck program identified areas for improvement in cervical screening and made a broad range of recommendations for all screening programs which included emphasis on quality assurance, the importance of audit, open disclosure, and improved linkage with the National Cancer Registry (NCR).
In January 2019, the HSE commissioned two Expert Reference Groups to “define the future audit processes and review guidance for interval cancers in the three cancer screening services in the ROI. The Interval Breast Cancer Expert Group Report was published in 2020. This report refers to interval cancer quality assurance in BreastCheck - Past and Present. It also makes recommendations for the future reporting and reviewing of interval cancers in BreastCheck.
Implementation Groups for each cancer screening program, a Legal Framework Group and a Communications Group were subsequently set up to see how the Expert Reports would be implemented. In addition, BreastCheck has been responding to new legislation around the National Patient Safety Bill where specific reference has been made to “Patient Requested Interval Cancer Reviews”.
The public and political outcry during and after these events highlights the gap in political, medical, and public understanding and expectations of screening. It emphasizes the difficulties that exists in conveying the benefits and harms of screening and the importance of realistic messaging and communications.
This talk outlines the impact that these events have had on breast cancer screening in the ROI and how BreastCheck has responded.
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