Wednesday, 9 October 2002
Dáil Eireann Debate
1092. Mr. R. Bruton asked the Minister for Health and Children the action he has taken to ensure a comprehensive gene testing regime can be put in place here for breast cancer; if all existing gene testing facilities for this ailment currently take place in Switzerland; and if he will make a statement on the matter. [16351/02]
Minister for Health and Children (Mr. Martin): The National Centre for Medical Genetics based at Our Lady's Hospital, Crumlin, was set up in 1995, following the Report of the Department of  Health Committee to examine Medical Genetics Services – the 1990 “Tierney” report. The NCMG is charged with providing a clinical and laboratory genetic service for the country as a whole. The NCMG provides a wide range of laboratory cytogenetic and molecular genetic tests.
Cytogenetic tests are carried out for constitutional chromosome disorders such as Down Syndrome, and are also carried out to help in the diagnosis and management of non-hereditary cancers, particularly leukaemia. For genetic tests not offered by the NCMG, the centre can arrange for such tests to be carried out by other laboratories in Europe. The centre does not charge public patients, hospitals or health boards for the costs of genetic tests carried out in the centre. Where a genetic test is carried out by an external genetics laboratory abroad, the cost of that test is passed back to the referring clinician and hospital.
The remit of the NMCG is principally the diagnosis, management, and counselling of families with genetic disorders, including describing genetic testing for genes involved in hereditary predisposition to breast and ovarian cancer – BRCA1 and BRCA2.
Genetic testing for inherited cancer syndromes falls into two categories, namely, finding a DNA mutation in a blood sample from a person affected by a cancer which is likely to be hereditary – diagnostic genetic testing; and testing healthy unaffected members of a family where a causative gene mutation has already been found – predictive genetic testing.
A diagnostic test identifies a family with hereditary breast cancer and can allow predictive testing for healthy family members. A predictive test can be highly indicative of a person's risk of developing cancer.
The department of medical genetics of University College Dublin, based at the NCMG, was awarded funding by the Health Research Board in 1998 to carry out a collaborative four year study on the implementation of testing for hereditary breast cancer in Ireland. This study has established the technology and expertise for screening for mutations in the BRCA1 and BRCA2 genes at the NCMG, and has provided important information about the frequency of particular breast cancer gene mutations in the Irish population. The study also established expertise in Ireland in assessing and counselling families with hereditary breast cancer.
The National Cancer Forum has recently established a sub-group on genetics to report to the forum with specific proposals for the further development and support of cancer genetics in the country. The work of this sub-group will inform the development of the National Cancer Strategy 2003-2010.
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