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Mr. Andrew Dismore (Hendon) (Lab): I understand that the hon. Gentleman recently met representatives of Breakthrough Breast Cancer. Will he tell us whether they support his Bill, and in particular, his view that the lower age at which women are called for mammograms should be reduced to 45?

Mr. Vara: I am mindful of the fact that, in our earlier debate, the hon. Gentleman said that he would exercise restraint. I understand that that is a quality that he is not used to exercising in debates on private Members' Bills, but bearing in mind the time constraint under which we are working, I hope that he will continue to exercise it today. I shall address the issue of lowering the age limit shortly. Had the hon. Gentleman been paying attention earlier, he would have noted that I said that I would clearly set out my proposals, and that I would address the issues of resources and the lower age limit. I shall come back to the point that he has raised.

Mr. Brooks Newmark (Braintree) (Con): I, too, congratulate my hon. Friend on bringing the Bill to the House. I hope that he will also address the important issue of the frequency with which screenings take place. Further to the constructive point made by my hon. Friend the Member for Kettering (Mr. Hollobone), I hope that women will be able to have screenings more frequently than once every three years—perhaps every two years, or even yearly—especially women over the age of 70, for whom this is an important concern.

Mr. Vara: I am grateful to my hon. Friend for raising that point and I agree that the more frequency we can have, the more detection we can have. Detection means prevention, and I will address the issue of the over-70s.

Mr. Dismore: The hon. Gentleman made a rather unjustified personal attack on me in response to an intervention. I simply say to him that my shortest speech on a Friday lasted three minutes and my longest three hours and 17 minutes. I hope to be able to speak for rather less time than that, but that depends on whether he deals with all the arguments. I speak to the issues, and some issues take longer to speak to than others.

Mr. Vara: I am grateful to the hon. Gentleman for putting that on the record. I am sure his record in previous debates speaks louder than any response that I can give.

Mr. Lee Scott (Ilford, North) (Con): I, too, congratulate my hon. Friend on introducing the Bill to
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the House. As he knows, I have first-hand experience of the issue, having lost my mother, at far too young an age, to breast cancer. The statistics show that, up to the age of 40, one in 200 people have a chance of contracting breast cancer, but the figure is one in 50 at the age of 50, which makes the Bill so much more important. Does he agree that it should be supported on both sides of the House?

Mr. Vara: I am grateful to my hon. Friend for raising that point. Yes, as a woman's age rises, so the risk of getting this dreadful disease increases. I shall also come to that in due course.

When screening is done at an early stage, it can reveal breast cancer before the onset of symptoms. It means fewer mastectomies, less cost of treatment, and less pain and suffering. In 2003–04, the programme detected more than 11,200 breast cancers, more than 3,000 of which were very small and would have been impossible to detect through self-examination. Incidentally, a petition presented in the Scottish Parliament calls for the age at which screening should commence to be lowered to 30. Let me assure the Minister of State that I am in no way advocating dropping the age to 30. I am confining my limit to 45.

As for the upper age range, from 70 to 75, women can volunteer and request a screening every three years, but the simple fact is that many do not. Some women believe that they are safe because they are no longer routinely invited for screening. The reality is that the risk of breast cancer increases with age.

Mr. Mark Lancaster (North-East Milton Keynes) (Con): Does my hon. Friend agree that one of the principal problems is that in areas of high population mobility such as Milton Keynes, women simply move on too quickly and do not always go for screening? How would his Bill help, and what can we do to increase the frequency of screening?

Mr. Vara: I agree with my hon. Friend that mobility and a host of other factors contribute to the fact that women do not follow things up. The best solution is to ensure that women are given a reminder. There are other reasons why people post-70 do not volunteer themselves. I will come to those.

Angela Browning (Tiverton and Honiton) (Con): As a sponsor of my hon. Friend's Bill, I am pleased that we have time to debate it today. On the question of women aged over 70, I have read that the NHS reason for not offering them screening is that should breast cancer present at that stage, it is not considered an early death and that other diseases start to kick in. I really do not agree with that. Quite clearly, if somebody develops breast cancer post-70 and it is not detected, it will spread to other parts of the body and become a terminal illness. Surely we are not only talking about preventing early death, important though that is, but trying to consider preventing death by cancer per se.

Mr. Vara: I am grateful to my hon. Friend for those comments. I agree that one of the reasons that has been given for the situation is co-morbidities—that, I think, is the technical term referring to other diseases and conditions. But women are now living healthier, longer
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lives, and that has to be taken into account with reference to what my hon. Friend said. We must also recognise that if we are to treat the elderly in our society as equal citizens, our policies must reflect the fact that they are living healthier, longer lives, which includes having routine screening for women aged between 70 and 75.

Society puts a certain amount of pressure on the elderly. They are made to feel that they are a burden on the state, so many women are reluctant to make a self-referral, feeling that they would only add to that burden. Elderly people can be forgetful, and if we in this Chamber are often forgetful and need to carry pieces of paper to remind us of things, who is to say that, with the onset of age, women will remember to make a self-referral every three years? Many elderly women who have a lump in their breast may simply say, "It is just another thing that you get when you get old," and simply dismiss it rather than taking it seriously.

Routine screenings for women between 70 and 75 should not be a problem. From an administrative point of view, those women are already in the system. Screening is technically easier, as the breast tissue is not as dense as that in younger women. Mammograms are therefore easier to read, and false negatives and false positives are rarer. Put simply, women are living longer; they have healthier lives; and the cancer is easier to detect.

With reference to the lower age group, 45 to 50, the obvious statement is that women do not have to wait until they are 50 before the dreadful disease of breast cancer can strike. Much is made of the fact that, comparatively speaking—the key word there is "comparatively"—80 per cent. of all diagnoses are for women over 50. That is not to say that the other 20 per cent. is not a significant number in its own right.

Jo Swinson (East Dunbartonshire) (LD): The hon. Gentleman rightly points out the higher incidence of breast cancer in older women. On detection, although screening is important, does he agree that there are many cases of younger women contracting the disease—including the recent high-profile cases of Kylie and Anastacia—so it is important for all women, regardless of age, to be aware of any changes in their breasts, because that, too, will facilitate early detection?

Mr. Vara: I am grateful to the hon. Lady for highlighting that very relevant point. I mentioned earlier the recent survey by the charity Breakthrough Breast Cancer, which found that 47 per cent. of women do not know how to perform a self-examination, and 80 per cent. certainly had not done so in the previous month.

I return to the 20 per cent. of women with breast cancer who are dismissed, on a comparative basis, because they are under 50, meaning that the under-50s are not given due consideration. Of the 41,000 women who are diagnosed every year, the 20 per cent. of those aged under 50 number 8,200. In 2003–04, about 1,400 of those women died.

I welcome the present policy of allowing annual screenings for women aged between 40 and 49 for those who have a family history of breast cancer. But we need
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to go further. I am encouraged by the trials in Sweden that screened women between 40 and 50 in 2003. Certainly, that has encouraged some of the charities.

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