Cancer incidence, mortality, treatment and survival in Ireland

Survival rates for cancer are continuing to rise even though the number of cases being diagnosed is increasing, an all-Ireland report reveals.

The report entitled Cancer incidence, mortality, treatment and survival in the North and South of Ireland: 1994-2004, was compiled by the Northern Ireland Cancer Registry (NICR), at Queen's University Belfast, and the National Cancer Registry (NCRI) of Ireland, in Cork.

This is the third joint report between the NICR and the NCRI and reveals that each year over 21,000 people across Ireland are diagnosed with a form of cancer, with the most common being breast, colorectal, prostate and lung cancers.

Between 1994 and 2004 the most common cancers among men were prostate, colorectal and lung cancers and lymphoma, while among women breast, colorectal, lung and ovarian cancers were most often diagnosed.
 
According to its authors people can take action to prevent certain forms of cancer including stopping smoking, reducing their alcohol intake, following a healthy diet, exercising and taking care in the sun.

Total incidence rates were 10 per cent higher for men and 2.2 per cent higher for women in the Republic of Ireland compared with Northern Ireland. The difference for men was mainly due to differences in prostate cancer diagnosis through increased testing in the Republic.

The report also showed that mortality rates were around 4 per cent lower in Northern Ireland for men and women.

While the overall number of cancers has increased due to population growth and ageing and increased detection for some cancers including prostate and breast cancer, the number of cancer deaths has fallen.

Improvements in survival for breast, colorectal and prostate cancer were recorded over the last decade and survival rates are not falling for any cancer.

Dr Anna Gavin, director of NICR, said: "This is the first time we have been able to compare treatment differences in addition to the usual incidence, mortality and survival.

"Surprisingly, even though we are dealing with two different healthcare systems there is remarkably little variation in treatment, with improvements over time in both countries. Cancer is a significant burden on health and this comparative analysis will point to areas for further research to improve cancer prevention and standardise care for patients.

"Over 94,000 people who were diagnosed with cancer between 1994 and 2004 were still alive at the end of 2004. Many of them have been cured but many others still need care and treatment so support services are extremely important."

Dr David Donnelly, lead author of the report, said some of the major cancers in Ireland were preventable: "Lung, oesophageal, stomach, head and neck, kidney, bladder and cervical cancer all have a common risk factor in tobacco use.
"Most of these cancers especially lung, oesophagus and stomach have very poor survival.

"Tobacco use is also a major factor in explaining higher rates of cancer in the urban areas of Belfast, Dublin, Cork and Derry and in the most deprived geographic areas in Ireland compared to the most affluent. Fortunately incidence of several smoking related cancers has fallen among males, although incidence of lung cancer among females in Ireland is increasing.

"Poor diet and obesity also increase the risk of several cancers, including breast cancer and colorectal cancer, two of the major cancers in Ireland. Improvements in diet and increased physical exercise would likely result in a reduction in the levels of colorectal cancer, and help reverse the increases in breast cancer seen over the last decade."

Dr Harry Comber, Director of the NCRI, said increased testing for prostate cancer in the Republic of Ireland had made a difference to the figures: "Comparing survival between the North and South of Ireland reveals that five-year survival for men was higher in the Republic of Ireland than in Northern Ireland by 5.2 per cent, while there was no difference for women.

"The difference for men is a result of greater survival from prostate cancer in the Republic of Ireland, a side effect of increased tests to diagnose it. Excluding this cancer, male survival is the same in each country.

"Survival is the real test of countries' programmes of prevention, early detection and treatment."

The report was launched at the Royal College of Physicians of Ireland in Dublin by Irish Minister for Health and Children, Mary Harney.

Speaking at the launch she said: "I welcome the fall in cancer mortality and continued improvements in cancer survival in Ireland which have been increasing faster than most other countries'

"I acknowledge the role of the National Cancer Control Programme in reducing the burden of cancer and the importance of prevention through smoking cessation and following a healthy lifestyle."