An all-Ireland survey found death rates from breast cancer did not change in the Republic between 1994 and 2000. The opposite was the case in the North, where death rates fell by one fifth in the same period, and where nationally sponsored screening programmes are in place since 1993.
The report - ‘All Ireland Cancer Statistics Second Report 1998-2000’ - recommends the Republic increase its breast cancer screening services, currently limited to the Eastern Regional Health Authority, Midland Health Board and North Eastern Health Board areas and Wexford.
Further roll-out to Carlow and Kilkenny and southern and western counties, announced by Health Minister Micheál Martin last year, has not yet taken place. A spokesperson said the roll-out “requires detailed planning to include essential infrastructure”.
Two project teams in the south and west have been established to develop briefs for the capital infrastructure.
Dr Anna Gavin of the Northern Ireland Cancer Registry, one of the report’s authors, said comprehensive screening in the North “shows the benefit of mammography services, which we hope will come to the South”.
She said breast cancer rates in Northern Ireland were falling by a rate of 4% per year. Another of the report’s authors, Dr Harry Comber of the National Cancer Registry, said centralised treatment in the North also played a part in lower rates there.
For women, breast cancer is the leading cause of cancer and the leading cause of cancer-related death. New all-island cases were up 28.1%, an average of 2,715 per annum, between 1998 and 2000. Lung cancer, of which cigarette smoking is the primary cause, was up 9.7% in women and 15.9% in men.
The report’s authors said they expect the smoking ban to “profoundly lower the rates of lung cancer, the country’s leading cancer killer”. They called for the ban to be extended to the whole island.
Deprived urban areas have the highest incidence of lung cancer, the report found. In Belfast the rate was 72 cases per 100,000 and in Dublin 58 per 100,000. This compares with a national average of 46 per 100,000 and much lower rates in Clare and Monaghan at about 30 per 100,000. In Cork the figure was 40 per 100,000.
Incidence and death rates from prostate cancer, the leading cause of cancer in men, were far higher in the Republic. Between 1994 and 2000, the number of new cases jumped by 33% and by 22% between 1998 and 2000 alone. In Northern Ireland there was no change in new cases during the same period and death rates fell by 12%. However, the report concludes the benefits of prostate screening are unclear.
Colorectal cancer for both sexes combined is the leading cause of cancer in Ireland, and the second leading cause of cancer-related death. The eastern seaboard region has significantly more cases and the incidence in men is 1.5 times higher than in women.
One third of those found to have stomach cancer are over the age of 65. Dr Comber said Ireland has a very high rate of bowel cancer. Deaths are 62 per 100,000 in Ireland compared to 54 per 100,000 in the EU and US. Dr Comber said weight reduction and improved diet could reduce rates.
Overall, the authors conclude the findings support the planned extension of the National Breast Screening Programme in the Republic of Ireland.
Each year there are over 19,000 new cancer cases and 11,000 cancer deaths throughout Ireland.