Dr Muiris Houston, Medical Correspondent, analyses the significance of yesterday's report on women and cancer
The report, Women and Cancer in Ireland 1994-2001, brings together in one place, and for the first time, information on cancer in women in the Republic.
Reflecting the joint efforts of the National Cancer Registry (NCR) and the Women's Health Council (WHC), it is an important document that adds to our knowledge base of cancer in women.
Between 1994 and 2001, an average of 6,201 women were diagnosed with cancer each year.
The three commonest cancers were breast, colorectal and lung. The number of deaths annually from the disease was 3,474.
It is estimated that about 3 per cent of the population have survived cancer. Interestingly, women are twice as likely as men to survive cancer, a reflection of the type of cancers they get and the relatively high survival rates for female reproductive system tumours.
An analysis in the report of the Irish Cervical Screening Programme, which is currently only available to women in the mid-west region, illustrates the slow pace of health reform.
In 1992, a cervical screening committee was set up by the Minister for Health. It recommended the establishment of a national cervical screening programme; a ministerial decision was made to implement this in 1997.
By 2000, the pilot scheme in the mid-west was launched and has been running successfully. But although Mary Harney has recently promised a national programme, a 2004 report found that an 18-month transition period is required to standardise all cytology laboratories in the State before this can happen.
Recommending that women be screened for cervical cancer every three to five years from the age of 25, the Women and Cancer in Ireland report states: "There is no doubt that a well-organised, high-quality, smear-based cervical screening programme will substantially reduce the incidence of, and mortality from, cervical cancer."
But on behalf of the 180 women newly diagnosed with cervical cancer each year and the 73 relatively young women who die from the disease, the question must be asked: why, when the evidence internationally was so convincing, has it taken 14 years to reach a point where there is still no firm date for the implementation of a national cervical cancer screening programme?
The report highlights some interesting geographical differences in cancer incidence. Nationally, the number of cases of cervical cancer was higher than expected in the east and midlands and lower in the west.
Overall, the eastern region appears to have higher rates of cancer than other areas - a reflection of greater disadvantage and higher population density in the region.
European geographical variations also emerge: the Republic has the highest rate of ovarian cancer in Europe.
The incidence of colorectal, lung and pancreatic cancers here is greater than the European average.
Two vulnerable groups of women emerge from the report. Treatment and survival rates for cancer are lower among women from disadvantaged groups.
For example, while the incidence of colorectal cancer was found to be higher in women from more affluent groups, the chance of having surgery to treat cancer of the bowel was significantly lower for women from more deprived areas.
Clearly, there is a need to raise awareness of risk factors and to develop specific health promotion campaigns for disadvantaged women.
The issue of access to healthy lifestyle choices for women in more deprived areas will have to be addressed.
Older women also lose out. They are less likely to receive treatment for cancer than women in younger age groups. With women living longer than men and the general ageing of the population, the reasons for this anomaly need to be researched and the unacceptable inequity put right.
The Women's Health Council and National Cancer Registry report will help to inform the new national cancer strategy, due for publication later this year.
And the report may benefit men also.
As Prof Cecily Kelleher, chairwoman of the WHC, points out in her introduction: "Women actually do better than men in trends and patterns of some cancers and in many lifestyle risk determinants and, therefore, the public health need is for men as much as women."