Cancer patients on lower incomes have 'radically different outcomes' compared to better-off, Dáil told

Irish Cancer Society chief executive Averil Power said a key difference is people with health insurance can quickly pay for MRIs and other scans. Picture: Shane O'Neill

It is “horrifying” people are dying of cancer in Ireland because of financial barriers to care, the Oireachtas health committee heard on Wednesday.

Irish Cancer Society chief executive Averil Power said people see “radically different outcomes” in areas where people have lower incomes, even compared to neighbouring suburbs in Dublin.

This follows a National Cancer Registry Ireland report which warned of a 7% higher risk for men and a 5% higher risk for women of developing cancer overall for people living in more deprived areas compared with those in more affluent areas.

“The earlier cancer is caught the easier it is to treat and the greater the person’s chances are of surviving the disease,” Ms Power told the committee.

“For instance, the five-year survival rate for colorectal cancer is 95% if diagnosed at stage I. However, at stage 4 this falls to just 10%. Similarly, five-year survival for breast cancer is 94% at stage I and only 19% at stage 4. For ovarian cancer, it is 83% at stage I and only 15% at stage 4. Early diagnosis can literally be the difference between life and death.” 

She said a key difference is people with health insurance can quickly pay for MRIs and other scans.

“The Irish Cancer understand that there are currently more than 200,000 on the waiting list for radiology,” she said. “150,000 of these have been waiting longer than three months for a vital scan, despite the target in Sláintecare being just 10 days.” 

She told Social Democrats health spokeswoman Róisín Shortall it was not clear whether Ireland has a low number of radiology therapists because of low trainee numbers or high emigration rates among medics.

Director of advocacy Rachel Morrogh said diagnostic centres were needed. These should be separate to emergency care, she said, which would give uninterrupted access to scans and tests.

She gave an example of a woman who spent nine months on a radiology waiting list for back pain which turned out to be metastatic cancer.

A number of committee members, including Sinn Féin TD Thomas Gould, raised concerns about cancer patients with terminal diagnosis using overcrowded emergency departments to access care in a crisis.

Ms Power said in other countries there is broader access to dedicated emergency oncology pathways.

Governance was also raised as a concern, with Ms Morrogh highlighting the National Cancer Care Programme (NCCP) lost some powers when it was moved from the Department of Health to the HSE.

The NCCP also addressed the committee, with national director Professor Risteárd Ó Laoide saying: “The most recent estimate from the National Cancer Registry is that 10%-11% fewer cancers were diagnosed in 2020 compared to expected numbers.” 

He said: “We will not fully understand this impact for a number of years.” 

However, he also highlighted progress including an Acute Oncology Nursing Programme, which allows nurses treat cancer patients in crisis outside of emergency departments.

He pointed to EU research showing Ireland ranks in the top half of countries surveyed for survival rates among 14 out of 18 tumours, and among the remainder “significant improvements” are being seen.

In response to Fine Gael TD Colm Burke, who said a family member who never smoked died with lung cancer this week, he said a pilot study was being prepared around rapid access lung health programmes and they support this.