New cancer strategy to extend screening services

An extension of bowel screening services, the centralisation of surgery for more cancers and a new emphasis on survivorship programmes form part of the new National Cancer Strategy to be published on Tuesday.

The BowelScreen programme, currently available to men and women aged 60-69 every two years, is to be extended to the 55-74 age group by 2021.

New measures are planned to further reduce smoking levels and GPs will be given access to cancer diagnostics, according to the 10-year strategy.

The cost of new “exceedingly expensive” cancer treatments will pose an ongoing challenge during the 10 years of the strategy, the document warns.

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It is understood the strategy will cost €150 million a year, or €1.5 billion over the period of the plan, but the amount will have to go through the estimates.

A cancer patient advisory committee is to be established to give patients greater input into control measures and the Department of Health will ensure patient representatives are involved in policymaking and planning at all levels.

Survivorship programmes

With more patients surviving cancer, and many returning to work or playing a full part in later life, the National Cancer Control Programme will develop survivorship programmes for patients. Patients will also be provided with care plans to guide them towards self-management of their care.

The aims of the plan are modest compared to those in the last strategy published in 2006, which resulted in the number of cancer treatment centres being cut from 35 to eight and the recruitment of scores of additional specialist staff. It is also being published late, as the previous strategy ended 18 months ago.

Cancer prevention will be a “cornerstone” of the new strategy as it offers the most cost-effective, long-term approach for controlling the disease, the plan states.

Up to 40 per cent of cancers are linked to modifiable lifestyle and environmental factors such as smoking, alcohol and physical inactivity.

The reduction of health inequalities and the early detection and diagnosis of cancer are also cited as priorities.

Capital investment will be required to ensure high-quality facilities are available for patients and staff as patient numbers continue to increase.

Integration of services

The strategy says the centralisation of surgery for more cancers will be progressed to ensure optimal treatment is provided and better outcomes achieved. An expansion in radiation oncology is envisaged.

The plan envisages greater specialisation by oncologists and haematologists as the volume of work increases, leading to a need to recruit more staff.

Despite improvements in survival rates, the number of people dying from cancer is set to double by 2040, mainly due to the ageing of the population.

The proportion of deaths attributable to the disease has also risen, from 20 per cent in the 1980s to 30 per cent at present.

There are now 150,000 people with cancer living in Ireland and the strategy says cancer survivorship will be a main priority over the next decade.

Increased demand has led to capacity and resourcing issues, particularly in relation to staffing, the strategy acknowledges.

It calls for greater integration between hospital services and services in the community before, during and after a patient’s treatment.

Other recommendations include the provision of age-appropriate facilities for adolescents and young adults with cancer within the new national children’s hospital, and the appointment of a national clinical lead for cancer nursing.

While cancer incidence and survival rates have improved in Ireland over recent decades, they lag behind European averages for many specific tumours.