It may take up to 20 years for Ireland to move to the top of the survival league for all cancers, despite the major changes under way, it was warned yesterday.

Ireland's survival rate from all cancers five years after diagnosis is the 18th worst of 23 European countries and, although a major programme of change is being rolled out, it will take years before significant improvements are registered, the National Cancer Control director said yesterday.

Professor Tom Keane also insisted the controversial transfer of breast cancer services to eight specialised hospitals would go ahead and was on schedule to be completed by late spring.

A priority this year will be tackling the late diagnosis of cancers such as lung and prostate cancer and Prof Keane said he was on track to open eight rapid-access clinics around the country for these patients over the next 18 months.

Around half of these could be in place this year and it will allow GPs who have patients with suspicious symptoms to refer them to clinics to speed up diagnosis and improve the chances of survival.

"For different cancers, survival rates are very different," Prof Keane said. "For lung cancer, you can find out within three years whether you are doing much better, certainly within five. For prostate cancer, you may have to wait 15 years to see the impact. For breast cancer, five years is used, but 10 years' survival and 15 years' survival may be better indicators.

"It is going to take years rather than months and, in most cases, three and up to 15 years to see the outcomes you want for different cancers," he pointed out.

Prof Keane, who was speaking to volunteers from around the country involved in fundraising for Daffodil Day, was challenged by Rhoda Barrett, of Tempeboy, Co Sligo, who pointed to the plight of a radiotherapy patient -- recently highlighted in the Irish Independent -- who had to wait 20 hours for a bed in Galway.

Reflecting on the opposition in Sligo to the loss of breast cancer services to Galway, she asked: "Why do patients have to take the rickety road from Sligo to Galway? Why can't the service stay in Sligo until there is room in Galway?"

Prof Keane reassured her that services would not be transferred until he was satisfied Galway was ready.

He said only about one additional bed for Galway was needed to accommodate patients from Sligo, as the majority of surgery is now carried out on a day-basis. Half the patients are also going to Dublin hospitals.

He expected breast cancer services in Drogheda to be transferred to Beaumont Hospital this month and completed in March.

Transfer

Tallaght Hospital services will transfer in April and renovations are under way in Cork University Hospital to accept the service from the city's South Infirmary. The aim is to have breast cancer diagnosis and surgery confined to the eight hospitals before the summer.

Other changes under way include training GPs to cater for some patients and reduce dependence on hospitals, and looking at the use of new expensive chemotherapy drugs to ensure a uniform system is in place.