Cancer is a deadly disease, responsible for about one- quarter of annual fatalities in Ireland. It is also one about which a lot more is known now medically and socially than several decades ago.
With proper screening and preventive action, lives can definitely be saved. As a result, the issue has become much more sensitive politically.
All the more reason, then, to welcome the detailed study of the incidence of cancer among women in the years 1994 to 2001, published yesterday by the National Cancer Registry and the Women's Health Council. It points up a number of existing inequalities in monitoring and treating the disease - including those between women and men. There are clear lessons here for future public policy.
On average, 6,201 women were diagnosed in each of these years - most commonly with breast, colorectal and lung cancers - and 3,474 women died. Both figures are increasing because of longer life-expectancy and population growth. Women have twice as high a survival rate as men from the disease, reflecting the cancers females get and their treatability. It makes a great and proven difference when these cancers are diagnosed as early as possible.
But the report shows substantial geographical and social inequalities in the availability and provision of screening and treatment. There have been long delays in rolling out screening. Cervical screening was first mooted here in the early Nineties, but it has only been available in one region since 2000 and will not be available nationally for several more years. National breast screening is still selective, although tenders are out which should put it in place by 2008. These delays have meant - and still mean - more women will die than should do.
Breast and skin cancers are more prevalent among women from more affluent areas, while rates of the disease in the lung, cervix, pancreas and stomach are higher among women in poorer ones. There are marked differences in the levels of treatment offered to younger and older women. These reflect an accumulation of professional medical judgments about how effective and risky treatments are at current levels of knowledge. The pace of change in basic knowledge and techniques can change these perceptions, just as they have changed the traditionally nihilistic attitude of many doctors towards lung cancer, regarded as self-inflicted and often diagnosed too late for treatment.
Professor Cecily Kelleher points out in this report that women do better than men in the trends and patterns of some cancers and in relation to many of the lifestyle factors putting people at risk. Thus the public health lessons to be drawn from the research apply across the board and are not confined to women. More public policy as well as medical debate is needed to address these imbalances and to catch up with the best international practice in treating cancer.