1994-2001: improvements seen in survival for most cancers, but regional differences persist.

The National Cancer Registry this week released analyses showing that there have been significant improvements in survival for breast, colorectal and prostate cancers, but not lung cancers, between 1994-1997 and 1998-2001. Improvements in treatment or in early diagnosis are presumably involved. However, variation in survival between regions is still apparent, with survival generally best for patients with breast, colorectal and prostate cancers resident in the Eastern region.

The substantial improvements in prostate cancer survival may be more illusory than real, because of apparent increases in the use of PSA (prostate-specific antigen) testing. ‘Screening’ for prostate cancer by PSA testing is still controversial, and has not been proven to reduce mortality from prostate cancer.  However, the very fact of early detection can increase the apparent survival of the ‘average’ prostate cancer patient, simply because these patients are now aware of their cancer diagnosis for longer.

Trends in treatment appeared to be broadly in line with expectations of greater or better-targeted use of radiotherapy and chemotherapy. However, as for survival, the likelihood of cancer patients receiving a given treatment still varies substantially between different parts of the country.  These variations are largely unexplained by patient and tumour characteristics, suggesting that the treatments offered by clinicians, or chosen by patients, may be as dependent on local policies and ease of access to services as on the seriousness of the cancer or the patient’s suitability for treatment.

There was little evidence of a move to increased specialization or centralization of cancer services, with approximately the same number of hospitals and consultants treating cancers over the eight-year period. Further analyses planned by the National Cancer Registry will examine the appropriateness of treatment (in relation to available guidelines) and the possible influence of hospital or surgeon case-loads or specialization on the survival and quality of care of cancer patients.

This report confirms a modest improvement in survival for three of the four major cancers, in line with that seen in the rest of Europe. However, the fragmentation and inconsistency in treatment services noted in previous analyses had not greatly improved by 2001.

*Walsh PM, Comber H. (2006) Patterns of care and survival of cancer patients in Ireland 1994 to 2001: time-trends and regional variation for breast, colorectal, lung and prostate cancer. Summary report. National Cancer Registry, Cork.  A fuller version of this report is available online at www.ncri.ie.                                                                                                

Building 6800
Cork Airport Business Park
Kinsale Road, Cork T12 CDF7
Email Contact us here
Tel: +353 (0) 21 4318014
Fax: +353 (0) 21 4318016

NCRI directions

Go to top