Meeting of the Parliament

Meeting date: Tuesday, May 21, 2013

Official Report 883KB pdf

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Topical Question Time

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Breast Cancer (Genetic Risk)

1. To ask the Scottish Government what criteria are used to test patients to identify their genetic risk of developing breast cancer. (S4T-00360)

Cancer remains a top clinical priority for the Scottish Government. Through the implementation of the better cancer care action plan, we are committed to ensuring that people with cancer in Scotland receive the best possible treatment and care. The chief executive’s letter issued in 2009 sets out the criteria for the management of women with a family history of breast cancer, and in April the Scottish genetics consortium agreed that it would be right to implement the National Institute of Health and Care Excellence proposals and extend genetic testing for people at risk of developing breast cancer to bring the risk estimation level down to 10 per cent. As with the NICE recommendation, it is planned that that will be implemented in June.

That said, it is important to stress that patient care is ultimately a matter for discussion between the clinician and the patient. This is an excellent opportunity for us to encourage people who have concerns to go to their general practitioner, who will advise as appropriate.

The cabinet secretary is obviously aware of concerns that women in Scotland might somehow be disadvantaged as a result of NICE’s decision to make more women in England with a genetic predisposition to breast cancer eligible for screening. I therefore very much welcome his confirmation that that will also be available in Scotland. That is very helpful indeed.

Given that the cabinet secretary and I agree that early detection and treatment are essential in treating cancer, will he consider how we can work together to implement Labour’s policy of halving the current waiting time for seeing a cancer specialist and getting results in two weeks?

First of all, the detect breast cancer early campaign, which was fronted by Elaine C Smith, has already led to a very welcome 50 per cent increase in the number of women presenting at their GPs. Secondly, I point out to Jackie Baillie that we have made substantial progress in reducing cancer waiting lists and waiting times as a result of the additional oncologists, clinical cancer nurses and radiographers who have been recruited in recent years. We will continue to ensure that our targets of 31 and 62 days respectively are met; indeed, they are being met and exceeded.

I share the cabinet secretary’s aspiration to do all that we can and very much welcome the additional staff who have been put in place. However, we can go further than that and I am sure that the cabinet secretary also agrees that swift treatment of those with cancer is essential the whole way through the system. Does he therefore agree that it is not acceptable for cancer patients to be left waiting for follow-up treatment with no guarantee of being seen quickly and no information on how long patients wait beyond that initial period of treatment, and does he agree that improvements should be made in this area?

We are making improvements all the time. However, once the initial period of referral, diagnosis and then referral for treatment is over, it is up to the clinicians and the patient to determine the pace of any further treatment that is required. That issue is already covered in great detail by clinical guidelines and, although we do not have targets for turnaround times as they do south of the border, we are absolutely sure that clinical guidelines are the way to go, because they are very patient centred and focused on a particular patient’s needs. Of course, one patient’s needs will be different from those of another patient and we must ensure that the whole system is patient centred.

I also point out that the mortality rates for all sorts of cancers across the board has fallen by 10 per cent over the past 10 years or so and 6 per cent in the past five years. That is a welcome development.

Given that, as we all know, it is important for breast cancer to be detected and diagnosed as early as possible to give greater chance of more successful treatment, can the cabinet secretary provide an update on what impact the groundbreaking breast cancer campaign featuring Elaine C Smith that he mentioned earlier has had in raising awareness of breast cancer symptoms since its launch last September?

As I have said, the number of GP consultations relating to breast symptoms increased by approximately 50 per cent during the successful detect breast cancer early campaign. Approximately 21,000 women consulted their GP with regard to breast symptoms such as lumps, pain or infection. That is a significant increase on the figure for the same period in 2011, when there were approximately 13,900 consultations. Although it is too early to say what impact these consultations have had on the rate of diagnosis, we will publish an evaluation in due course.

That concludes topical question time.