There has been a marked improvement in treatment and survival rates among cancer patients in Ireland in recent years, however geographic disparities are still evident, a new report has found.

The report from the National Cancer Registry Ireland (NCRI) looks at patterns of care and survival between 1994 and 2004. It is based on 138,349 malignant cancers that were diagnosed in patients aged 15-99 during this period.

In relation to treatment, the report found that the percentage of patients being treated surgically increased for some types of cancer, including breast cancer, but decreased for a number of other types, including lung, prostate and colorectal cancer.

At the same time, the use of chemotherapy increased considerably for a range of cancers including stomach, bladder, colorectal and lung cancer. For some cancers, the rate of chemotherapy use stayed the same, while not one type of cancer saw a decrease in the use of this type of treatment.

The use of radiation therapy meanwhile increased for some cancers, such as colorectal and prostate cancer and decreased for others such as breast cancer and skin melanoma.

The overall percentage of older patients (those over the age of 80) having surgery remained low, while the use of chemotherapy and radiation therapy within this age group increased.

The report found that variations in treatment uptake within the HSE areas were ‘of a similar magnitude as noted previously for the former health board areas’. Furthermore treatment ‘tended to be more frequent’ in the two HSE Dublin areas, although this was ‘not consistent’.

In relation to survival rates, according to the findings, the survival of patients diagnosed with almost all types of cancer showed improvement during the 1994-2004 period.

“Statistically significant improvements in survival were seen for cancers as a whole and for the four most important cancers in healthcare terms – colorectal, lung, prostate and breast cancer. However absolute improvements in survival were only minor for lung cancer, for which survival remains very low,” the report said.

It acknowledged that with regard to some types of cancer, such as breast cancer, ‘it cannot be ruled out that some of the apparent improvement in survival is an artefact of increases in screening’. However it pointed out that improvements in survival rates for the most common cancers suggest ‘improvements in appropriateness or availability of treatment’.

However the report noted some ‘marked differences’ in survival rates between 2000 and 2004 in relation to different areas of residence. For example, relative survival within five years of diagnosis for a person with colorectal cancer was significantly lower for patients treated in the HSE South area than for those treated in Dublin/Mid Leinster.

Survival was also ‘significantly poorer’ for patients treated for pancreatic and cervical cancer in the HSE South area and liver and pancreatic cancer in the HSE West area, compared to Dublin/Mid-Leinster.

The report highlighted the fact that during 2000-2004, colorectal, lung and breast cancer patients who were surgically treated in the eight hospitals proposed as specialist centres of excellence ‘had significantly higher survival compared with other public acute general hospitals’.

However it also noted that ‘colorectal, prostate and female breast cancer patients in private hospitals had significantly higher survival than those treated in the proposed centres, although interpretation of this finding is difficult because of the possible involvement of socioeconomic factors’.

According to the report’s authors, the findings ‘highlight the need to improve access to consistent levels of care for Irish cancer patients, a major aim of the National Cancer Control Programme and the ongoing reorganisation of cancer treatment services’.

The report, Patterns of Care and Survival of Patients in Ireland 1994-2004, can be downloaded from…http://www.ncri.ie/news/20081202.shtml