Cancer deaths 4% lower in North than Republic - report

DEATH RATES from cancer are 4 per cent lower in Northern Ireland compared with the Republic, a major report published today has…

DEATH RATES from cancer are 4 per cent lower in Northern Ireland compared with the Republic, a major report published today has found.

However, the report also noted that overall cancer survival continues to improve throughout the island.

Cancer incidence, mortality, treatment and survival in the North and South of Ireland: 1994- 2004, is the third joint report compiled by the Northern Ireland Cancer Registry (NICR) and the National Cancer Registry of Ireland (NCRI).

The report shows that more than 21,000 people on the island of Ireland are diagnosed with cancer annually.

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Most common cancers among men in the 10-year study period were prostate, colorectal, lung and lymphoma (a cancer of the lymph glands); among women breast, colorectal, lung and ovarian cancers were more often diagnosed.

The authors of the report say the overall number of cancers has increased due to population growth, an ageing population and the increased detection of some tumours. Cancer deaths have fallen, primarily due to better survival for patients with breast, bowel and prostate cancer.

Male cancer rates were lower in the North by 10 per cent because of higher levels of prostate cancer in the Republic. However, this does not mean the disease is more prevalent in the Republic; rather it is a reflection of the greater use of testing for the disease here.

Elevated levels of prostate specific antigen (PSA) in the blood may indicate the presence of prostate cancer. However, it appears that doctors following guidelines in Northern Ireland perform the test less often than their counterparts in the Republic.

Cancer rates were highest in counties and council regions with large urban areas, such as Dublin, Belfast, Cork and Derry. People living in deprived areas were also more likely to have cancer. Among males, overall cancer rates were higher than average in Dublin, Belfast Derry, Cork, Kildare, Wicklow, Westmeath, Waterford and Louth.

For females, rates were lower than average in 14 areas, most of which were along the western seaboard.

According to Dr David Donnelly of the NICR, lead author of the report, “tobacco use is a major factor in explaining higher rates of cancer in urban areas. and in the most deprived geographical areas in Ireland compared with the most affluent”.

He noted the incidence of some smoking related cancers had fallen among males, although lung cancer among females, North and South, is on the rise.

The incidence of cancer among men here was 4.6 per cent lower than the EU average while for women in Ireland cancer rates were 2.1 per cent higher.

The report found little difference in cancer treatments between the two jurisdictions. “Surprisingly, even though we are dealing with two different healthcare systems, there is remarkably little variation in treatment over time in both countries,” Dr Anna Gavin, director of the NICR, said.

Surgery was the most common treatment for stomach, colorectal, breast, cervical and ovarian cancer, while hormone therapy was most commonly used for prostate cancer. Radiotherapy was the most common treatment for oesophageal and lung cancer. Between 1996 and 2001 the use of chemotherapy and radiotherapy increased for oesophageal, stomach, colorectal, lung and breast cancers on the island.

Commenting on the prostate cancer findings, Dr Harry Comber, director of the NCRI said: “The difference for men is a result of greater survival from prostate cancer in the Republic of Ireland . . . Excluding this cancer, male survival is the same in each country.”

Muiris Houston

Dr Muiris Houston

Dr Muiris Houston is medical journalist, health analyst and Irish Times contributor