Key findings

          Between 1994 and 2001, an average of 20,523 cancer cases was registered each year. The commonest cancer by far was non-melanoma skin cancer (29% of all malignant cancers). If non-melanoma skin cancer is excluded, the commonest cancer in women was breast cancer (28% of all malignant cancers) and the commonest cancer in men was prostate cancer (21%).

          During the same period there was an average of 7,584 cancer deaths each year, about 25% of all deaths. Lung cancer accounted for 20% of cancer deaths (1499 per year) and was the commonest cause of death from cancer, although breast cancer (644 deaths) caused more deaths than lung cancer (534 deaths) in women.

          The number of cancer cases increased by 2.3% annually between 1994 and 2001. This increase seemed to be almost entirely due to changes in the size and age distribution of the population, with very little increase in the underlying risk of developing cancer. However, for some cancers—those of the kidney, prostate, testis and breast—there were significant increases in risk, of the order of 3-5% per annum, while for others—stomach, bladder, larynx and head and neck cancers—there was a significant decrease in risk.

          Cancer deaths increased much less than cancer numbers, by about 0.6% annually, and, when adjusted for change in the population size and age, there was an annual fall of about 0.9% in the overall risk of dying of cancer. The risk of dying of leukaemia, lymphoma, kidney and gallbladder cancer increased, while the risk of dying of cancers of the head and neck, bladder, stomach, breast and larynx fell.

          The incidence of many cancers—those of the oesophagus, stomach, colon/rectum, lung, non-melanoma skin cancer, breast, cervix and lymphoma—was higher in the east of the country.  This can be partly attributed to the higher prevalence of smoking in the east. Colorectal cancer, melanoma, leukaemia and prostate cancer had their highest incidence rates in the south, while cancer of the head and neck was most common in the west.

          The majority of cancer patients (60%) had surgical treatment; 20% had radiotherapy and 15% had chemotherapy. Most patients  had only one treatment type; only a quarter of all patients treated had combination therapy (e.g. surgery and radiotherapy), and 25% of patients had no cancer-directed treatment. The use of all treatment types varied considerably from cancer to cancer.

          For all treatments other than hormone therapy, rates of treatment were much lower in older patients. Those in the 70-79 years age group had treatment rates, a half to a third of those of patients aged 50-59, for most treatment types and common cancers.

          Surgery and radiotherapy rates rose only slightly between 1994 and 2001, but chemotherapy rates increased considerably for many cancers, and the overall uptake of chemotherapy rose from 13% of patients in 1996 to 18% in 2001, an annual increase of about 7%.

          Surgery rates for colorectal, lung, breast and prostate cancer were higher for patients living in the east, as were rates of radiotherapy (with the exception of prostate cancer). The geographical distribution of chemotherapy rates varied with cancer type; for colorectal cancer they were highest in the southeast and northwest, for lung cancer in the east, and for prostate cancer in the west. There was very little geographical variation in chemotherapy rates for breast cancer; but hormone therapy rates for breast cancer were high in Galway, as they were in the western region in general for prostate cancer.

Recent publications

1                  Mortality predictions for colon and anorectal cancer for Ireland, 2003-17. O'Lorcain P, Deady S, Comber H. Colorectal Dis. 2006 Jun;8(5):393-401.

2                  Nonsteroidal anti-inflammatory drugs and the esophageal inflammation-metaplasia-adenocarcinoma sequence. Anderson LA, Johnston BT, Watson RG, Murphy SJ, Ferguson HR, Comber H, McGuigan J, Reynolds JV, Murray LJ. Cancer Res. 2006 May 1;66(9):4975-82.

3              The role of immunosuppression in the pathogenesis of basal cell carcinoma. Moloney FJ, Comber H, Conlon PJ, Murphy GM. Br J Dermatol. 2006 Apr;154(4):790-1. No abstract available.

4                  Influence of mammographic screening on trends in breast-conserving surgery in Ireland. Walsh PM, McCarron P, Middleton RJ, Comber H, Gavin AT, Murray L. Eur J Cancer Prev. 2006 Apr;15(2):138-48.

5                  Mortality predictions for Ireland, 2001-2015: cancers of the breast, ovary, and cervix and Corpus uteri. O'Lorcain P, Comber H. Int J Gynecol Cancer. 2006 Jan-Feb;16 Suppl 1:1-10.

6              A population-based study of skin cancer incidence and prevalence in renal transplant recipients. Moloney FJ, Comber H, O'Lorcain P, O'Kelly P, Conlon PJ, Murphy GM. Br J Dermatol. 2006 Mar;154(3):498-504.

7              Delays in treatment in the cancer services: impact on cancer stage and survival. Comber H, Cronin DP, Deady S, Lorcain PO, Riordan P. Ir Med J. 2005 Sep;98(8):238-9.

8              Recent trends in cervical cancer mortality in Britain and Ireland: the case for population-based cervical cancer screening. Comber H, Gavin A. Br J Cancer. 2004 Nov 29;91(11):1902-4.

9              Lung cancer mortality predictions for Ireland 2001-2015 and current trends in North Western Europe. O'Lorcain P, Comber H. Lung Cancer. 2004 Nov;46(2):157-63.

10           Pleural mesothelioma incidence in Europe: evidence of some deceleration in the increasing trends. Montanaro F, Bray F, Gennaro V, Merler E, Tyczynski JE, Parkin DM, Strnad M, Jechov'a M, Storm HH, Aareleid T, Hakulinen T, Velten M, Lef'evre H, Danzon A, Buemi A, Daur'es JP, Menegoz F, Raverdy N, Sauvage M, Ziegler H, Comber H, Paci E, Vercelli M, De Lisi V, Tumino R, Zanetti R, Berrino F, Stanta G, Langmark F, Rachtan J, Mezyk R, Blaszczyk J, Ivan P, Primic-Zakelj M, Martinez AC, Izarzugaza I, Borras J, Garcia CM, Garau I, Sanchez NC, Aicua A, Barlow L, Torhorst J, Bouchardy C, Levi F, Fisch T, Probst N, Visser O, Quinn M, Gavin A, Brewster D, Mikov M; ENCR Working Group. Cancer Causes Control. 2003 Oct;14(8):791-803.

11                  Patterns of initial management of lung cancer in the Republic of Ireland: a population-based observational study. Mahmud SM, Reilly M, Comber H. Lung Cancer. 2003 Jul;41(1):57-64.

12                  Observational studies for intervention assessment. Comber H, Perry IJ. Lancet. 2001 Jun 30;357(9274):2141-2.