New report by the National Cancer Registry assesses the effect of deprivation on cancer

The National Cancer Registry (NCRI) has today published a new report entitled: Cancer inequalities in Ireland by deprivation, 2004-2018.  This report measures differences in cancer incidence, five-year survival and stage at presentation between populations living in the most and least deprived areas in Ireland for the diagnosis period 2014-2018.  Comparative information is also provided for earlier periods (2004-2008 and 2009-2013).

The report can be found here.

Key findings include:

• Overall, there was a 7% higher age-standardised incidence for males and a 5% higher incidence for females living in most deprived areas compared to those living in the least deprived areas in 2014-2018
• Overall, there was lower five-year cancer survival rates in patients from the most deprived areas compared to those in the least deprived areas. Those in the most deprived areas had a 28% higher mortality risk due to cancer within five years of cancer diagnosis compared to those in the least deprived areas, having adjusted for age, gender, and cancer type.
• Differences in the types of cancers diagnosed in the most and least deprived areas, with a higher incidence of stomach, lung and cervical cancer in people living in most deprived areas, while those living in least deprived areas show a higher incidence of breast, prostate, and melanoma and non-melanoma skin cancer.
• People living in the most deprived areas had a higher risk of late-stage presentation for breast and prostate cancers than those living in least deprived areas.  No disparities in stage of presentation were found for lung or colorectal cancers when comparing the least and most deprived groups.
• Although cancer incidence rates have fallen and survival rates have improved over time across the majority of cancers and for all sectors of society, there is no evidence of any reduction in disparities between those living in the least and the most deprived areas.

A range of potential factors may contribute to such disparities, including differences in general health, exposure to particular risk factors, health-seeking behaviour (influencing early detection), access to healthcare, or other factors that may be linked to socioeconomic or geographic factors. Disentangling these factors and their relative importance is far from straightforward, and many challenges remain in tackling the root causes of such inequalities.

Chair of the NCRI Board Dr Jerome Coffey, welcomed the report and said: “These important data underline the known links between socioeconomic deprivation and cancer incidence and survival, with no major reductions in disparities between groups over the time periods examined.  Prevention, screening and early diagnosis are major elements of the National Cancer Strategy 2017-2026 and will have to remain as priorities in subsequent strategies.”

NCRI co-author Dr Niamh Bambury said: “There is an increased focus on cancer inequalities experienced across the cancer continuum as part of Europe’s Beating Cancer Plan. Monitoring cancer inequalities is important to identify groups who might benefit from targeted risk reduction interventions and to assess the impact of cancer strategies. This report provides the most up-to-date, reliable information on the effect of deprivation on cancer incidence and five-year survival. The socioeconomic and individual factors that contribute to cancer disparities are manifold and require a whole system response. In the health field, advancement of policy initiatives, including Sláintecare and Healthy Ireland, are needed to help address the root causes of these disparities.”