Written Answers. - Cancer Mortality.
Ivor Callely
Question:
92
Mr. Callely
asked the
Minister for Health
if, in view of Deputy Callely's recent Parliamentary Question No. 123 on 18 February 1992, which highlighted the huge increase in cancer-related deaths in the country over the last decade, he will outline the way in which he intends to help reduce and prevent the growing number of deaths in Ireland from cancer, and if he will make a statement on the matter.
The gradual rise in cancer mortality over recent decades is a trend which has been experienced throughout the developed world. During the last ten years in Ireland the increases have been largely confined to the older age group with rates for older women rising most rapidly. The upward trend in cancer deaths has been offset by a parallel fall in mortality from diseases of the circulatory system as detailed in the reply to Parliamentary Question No. 123 on 18 February 1992.
Tobacco consumption is the major single cause of cancer mortality in Ireland. In seeking to reduce the percentage of the population which smokes, the Department of Health pursue an integrated strategy of legislation, education and fiscal measures. At a European level this country has always supported measures aimed at reducing the threat to public health from smoking. The current EC directive, restricting advertising and specifying the size and type of health warnings to appear on packets is largely in line with Irish legislation. We have also supported the recent Commission proposal to ban all advertising of tobacco products. As the Deputy is aware smoking is prohibited in a range of public places and in designated facilities, for example schools and public transport.
In 1986 the European Community established a Europe against cancer programme with the aim of reducing deaths from cancer in the Community by 15 per cent by the year 2000. The European Commission, in implementing the programme among member states, involves governmental and non-governmental organisations especially national cancer prevention bodies. In the Irish context the programme is implemented through a national co-ordinating committee, a multi-sectoral group chaired by my Department's chief medical officer involving the health promotion unit of my Department, the Irish Cancer Society, health boards, Irish College of General Practitioners and the Irish Heart Foundation. The scientific nucleus of the programme is provided by an EC committee of cancer experts on which the Department are represented. Under the programme, a wide range of prevention initiatives have been undertaken nationally on issues such as education/information on smoking, nutrition, screening, and the training of health professionals. Such initiatives under the cancer programme are part funded by the EC.
Important fiscal measures have been taken by the Government in recent years when it approved an increase of 10p per packet of 20 cigarettes in the 1991 budget and a further increase of 16p per packet in the 1992 budget. The numbers who smoke are expected to reduce as a result of these increases.
Anti-smoking advice from health professionals is also an effective medium for supporting current smokers. The health promotion unit has recently developed a general practitioners/public health nurses anti-smoking pack. It is aimed to assist such professionals in their work to advise their patients/clients who smoke, to give up. Information booklets on "Smoking and Health" and "So You Want to Stop Smoking" are issued with an accompanying manual. It is intended that this resource pack will also be made available to dentists during this year.
A major element of my Department's anti-tobacco strategy is school based. A range of programmes are in place.
Primary and post-primary schools nationally are involved in a "Health is Lookin Good" competition which since its launch in 1990 has concentrated on health issues with a particular emphasis on tobacco.
A complete range of health education classroom materials for use in primary schools will soon be available following their successful piloting in the functional area of the Mid-Western Health Board. The anti-smoking messages will of course be included in these materials.
The health promotion unit, the Irish Cancer Society and the Department of Education are developing, in conjunction with young people, a peer-led anti-smoking project called "Smoking Cessation and Reduction Action Programme" (SCRAP). This programme will commence later this year with a training seminar for senior cycle students. A total of 15 schools will be invited to attend. Four students and one teacher will be chosen from each school, and participants will be chosen on the basis of their leadership qualities and facilitation abilities. Following skills and leadership training, young people will return to school with the skills necessary to instruct their peers with regard to various aspects of their health-related behaviour and to initiate projects on this theme.
The substance abuse prevention programme is a comprehensive drug education programme. It is a joint Department of Health/Department of Education initiative. The programme which commenced on a two-year pilot basis in eight second level schools in September 1991 will continue this year. The overall aim of the programme is to enable students to develop their ability to take charge of their health and to make aware and informed decisions about the use of drugs, including tobacco in their lives.
A healthy school project is being developed. The overall aim of this project is to improve the health of the total school population, students, teachers, parents, school support staffs and those in the wider community.
It will be jointly co-ordinated by the Departments of Health and Education and issues dealt with will include the development of personal skills, the creation of healthy school environments and the encouragement of healthy lifestyles and communication networks for all within the school community and its environment. An anti-tobacco approach will be an important ingredient in this project.
Early detection and treatment of cancer is of particular importance. For example, cervical cancer is the cause of 60-80 avoidable deaths per annum. The cervical cancer smear test is available to every woman. In order to consider what further improvements can be made in the area of cervical screening I intend to reconvene the working group on cervical screening at an early date.
A diagnostic mammography service is also available on a referral basis to women at a number of public hospitals throughout the country. My Department are also supporting the Eccles breast screening programme currently underway at the Mater Foundation. This programme is part of a network of pilot schemes on breast cancer screening underway within the European Community. The screening phase of the pilot study will be completed in 1994. The study findings, including the uptake of the service by women in the target population, will be a major influence on any future decisions in relation to a national screening programme.
