An Oireachtas Committee has heard concerns that disruption to cancer screening programmes caused by the pandemic may lead to people presenting for treatment at later stages of the disease.
The head of the National Cancer Control Programme (NCCP) told the Joint Committee on Health that there is concern that screening delays will "lead to upstaging of cancers".
Professor Risteárd Ó Laoide said that cancer services are facing "significant challenges" arising from Covid-19, the cyber-attack on the HSE last May, and "historic capacity issues".
The committee heard that these capacity issues were flagged in 2018.
Professor Arnold Hill, NCCP national advisor, agreed that there is "anecdotal evidence" of people presenting with the disease at a more advanced stage.
But, he cautioned that we need to see the data to know what exactly is happening.
The committee heard that this would come from the National Cancer Registry in two years.
It also heard hopes that Covid restrictions would be eased further, as this would enable more cancer screening.
And screening rates are now back to pre-pandemic levels.
But Professor Fidelma Flanagan, Lead Clinical Director for BreastCheck, emphasised that Covid-19 continues to cause "major disruption to screening".
"We've lost a year", Prof Flanagan said, adding that "it will take years before we fully recover from this".
She told the committee that at one point "over two thirds of people in [her] unit got Covid", and some staff "are still out with long Covid".
Prof Flanagan also told Social Democrats co-leader Róisín Shortall that, because the incidence of cancer is low in those under 45, screening is not advised for women in that cohort.
But she said that BreastCheck is considering offering screening to those aged over 70 and under 50.
It "is definitely on our radar", Prof Flanagan said.
However, she added that there is no evidence of an increase in breast cancer in younger women.
"The biggest risk factor is an increase in age", she said.
Still, "the message to people under fifty - 'You can get breast cancer'", Prof Flanagan said, adding that breast awareness is important.
There was also a stark warning about a serious challenge facing cancer screening.
"There is a worldwide deficit of radiologists, and specifically breast radiologists", Prof Flanagan said.
She added that it is "one of the biggest difficulties" the programme is facing.
"I think we're up against it", she said. "It really challenges the future of this programme."
Prof Ó Laoide warned that it is a major issue right across the health services, likening it to a shortage of electricity.
The NCCP Director said that currently 3,500 women are diagnosed annually with breast cancer, but that this will rise to 4,650 a year by 2045.
One in seven women in Ireland will be diagnosed with breast cancer.
However, he noted that the mortality rate has fallen by 2% each year, from 1994 - 2016.
And about one quarter of cases are preventable, primarily through adopting a healthy lifestyle.
Prof Ó Laoide also said that BreastCheck is key in improving outcomes for people, through its role in early diagnosis.
Chief Executive of National Screening Services, Fiona Murphy, appealed to women who are not going to use an appointment to let BreastCheck know.
Otherwise that appointment is wasted, she said.
Currently, more than one in four women miss their appointment.
However, the uptake rate of around 72% rises for those women who have already used the service.
Prof Hills said one case of breast cancer in every 200 is male, and cannabis use is the single most common cause of breast cancer in younger men.
"Being breast aware goes for men as well", he said, agreeing with Committee Cathaoirleach Seán Crowe's suggestion that men also check their breasts.
