Editorials

Cancer care: A lot more to do

Some individual cancers, including melanoma and female lung cancer, continue to show worrying increases in incidence and mortality rates

A report from the National Cancer Registry shows a recent stabilisation in overall cancer risk among the Irish population, but some individual cancers (for example, melanoma and female lung cancer) continue to show worrying increases in incidence and mortality rates. Photograph: Alan Betson
A report from the National Cancer Registry shows a recent stabilisation in overall cancer risk among the Irish population, but some individual cancers (for example, melanoma and female lung cancer) continue to show worrying increases in incidence and mortality rates. Photograph: Alan Betson
Mon Nov 13 2017 - 00:02

There was good news in the recent annual report from the National Cancer Registry: the rate of cancer per head of population has fallen by 2 per cent annually for men and by 0.1 per cent for women. Overall five-year cancer survival now stands at 61 per cent for all tumour types – a significant increase from 44 per cent 20 years ago.

A move from a fragmented system of care to one that consolidates treatment in larger centres, with multidisciplinary care and decision-making, has contributed to the improvement. Cancer remains the second most common cause of death in Ireland, with an average 8,770 deaths annually. However, people diagnosed with certain cancers – breast, prostate and testis – now have a greater than 80 per cent chance of survival.

While this year’s report highlights a recent stabilisation in overall cancer risk among the Irish population, some individual cancers, including melanoma and female lung cancer, continue to show worrying increases in incidence and mortality rates.

Geographic inequity must be addressed if we are to avoid the postcode cancer treatment lottery of the past

In addition we have become one of the slowest in the EU to fund new cancer treatments after they have been approved by the European Medicines Agency. This denial of treatment for cancer patients must be addressed in the context of ongoing pressure on our health budget and the reality that paying for expensive new drugs will likely mean not funding other health services.

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Some 167,700 cancer survivors – 3.6 per cent of the population – were estimated to be alive at the end of 2015. This number will continue to grow, making the long-term support and follow-up needs of cancer survivors an important health priority. Specific proposals in the National Cancer Strategy 2017-2026 to help cancer survivors must be funded.

At the end of 2016 there were just 40 medical oncologists in the country, almost half of them concentrated in the Dublin/mid-Leinster region. This geographic inequity must be addressed if we are to avoid the postcode cancer treatment lottery of the past.