All-Ireland information centre is next logical step for governments

The report represents a major collaborative effort by the Northern Ireland Cancer Registry and the National Cancer Registry in…

The report represents a major collaborative effort by the Northern Ireland Cancer Registry and the National Cancer Registry in the Republic.

Covering the period 1994-96, it is an analysis of the data held by both registers in May/June 2000. The two registers use different methods of data collection and some of it has been reclassified in order that direct comparisons can be made.

The report details the incidence (the number of new cancer cases) and the mortality from cancer over a three-year period. The most common form of cancer in both males and females is non-melanoma skin cancer, and it is reasonable to exclude these from further analysis because they are slow growing, easily treated and rarely fatal.

Unsurprisingly, the next most frequent tumour in both sexes is lung cancer, with an incidence of 10 per cent. A more sobering statistic is that it is the most common cause of overall death from cancer; one in four cancer deaths in men and one in five cancer deaths in both sexes combined.

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The main culprit for the high incidence of lung cancer is smoking, emphasising yet again that prevention is so much better than cure. And as Ms Bairbre de Brun said in her speech yesterday, the lung cancer statistics are a spur to the joint anti-smoking initiatives planned by both Departments of Health.

Although they are less common, smoking is also implicated in the development of mouth, throat, bladder and kidney tumours.

The report also confirms there is a high rate of lung cancer in urban environments, which suggests a link with social deprivation and poverty, factors which are themselves strongly linked to smoking.

It is not unreasonable to suggest that decreasing poverty levels would both reduce the number of people starting to smoke and make it easier to encourage those who do, to quit.

A North/South comparison shows that the rates for all cancers combined were higher in Northern Ireland, if non-melanoma skin cancers are excluded. Among females, breast cancer rates were higher in the North; this may reflect the increased pick-up rate by the established breast cancer screening programme. In males, stomach, lung and testicular cancer rates were higher in the North. The rate of liver cancer was far higher in Northern Ireland, but as the actual number of cases are small, this finding may be exaggerated.

The Republic has the highest rate of oesophageal (gullet) cancer in females in the entire European Union. This is an unexpected finding. Gullet cancer is usually associated with high levels of smoking and drinking; there is nothing to suggest that women in the Republic drink and smoke more than their European sisters.

These high rates need further investigation to see whether a dietary factor may be to blame.

A more localised comparison between urban areas shows some interesting results. The all-cancer rates among males was slightly higher in Dublin and Cork but was significantly lower in Belfast, Derry, Limerick and Galway compared with other urban populations.

For women, the rates for malignant cancers were higher in Dublin and Cork and again significantly lower in Belfast and Limerick when compared with other city populations.

The report is also significant in that it was commissioned by the All Ireland Cancer Consortium which includes the US National Cancer Institute. This is an important link for cancer care in the island of Ireland, the next stage of which will be to introduce American models of fast-track cancer drug research.

A next logical step for both governments would be to set up an All-Ireland cancer information centre so that future reports in the area of cancer will not consist purely of statistics.

We need information on risk factor monitoring and an analysis of cancer patients' treatment outcome if we are to make a difference in the future management of people with cancer.