Dáil Éireann Debate, Tuesday - 22 June 2004
202 Mr. Durkan asked the Minister for Health and Children if he has studied the reports on the incidents of the various forms of cancer throughout the country by county; if he can attribute any cause or causes for variations throughout the country; and if he will make a statement on the matter. [18636/04]
Amharc ar fhreagraReports of the national cancer registry have examined variations in incidence of cancer among counties and health board areas during the period from 1994 onwards. Variations in case numbers, overall or for particular cancers, obviously reflect variation in population size or in population age structure. Age-standardised rates show less variation, but nevertheless some variation is evident, although, for most counties or health authority areas, rates do not show statistically significant variation from the national average. The main exception is Dublin and the ERHA region, where incidence rates are higher than the national average for cancers as a whole, and for a number of individual cancers, including lung, breast and prostate cancers. For lung and a number of other cancers, variation is strongly influenced by smoking, which tends to be most prevalent in urban, particularly deprived urban, areas. For breast and prostate cancer, incidence rates may be increased in areas where there are higher levels of screening, e.g. breast screening. In general, cancers not strongly influenced by smoking, socio-economic or screening-related factors show less marked variation within Ireland, and any such variation cannot readily be attributed to specific factors without further research into specific cancers. Distinguishing true geographic variation from random or chance variation is also a problem given the small numbers of cases involved at county level for most cancers.
Since 1997, significant developments in cancer services have taken place in all regions. The overall additional cumulative funding in cancer services in this country since 1997 is in excess of €550 million including an additional €15 million revenue which I allocated this year. An additional 92 consultant posts in key areas of cancer treatment and 245 clinical nurse specialists across all health board areas have been funded. There has also been approximately €95 million in capital funding allocated specifically for the development of cancer related initiatives. These include an investment of €60 million in radiation oncology, and €11.9 million in BreastCheck.
The investment and appointments in cancer services have resulted in substantial increases in activity levels across the three modalities of care of radiation oncology, medical oncology and surgical oncology. For example, since 1996 the annual number of discharges of patients receiving chemotherapy has more than doubled, from 22,000 in 1996 to over 50,000 in 2002. Similarly, for radiotherapy the increase in discharges reported at Cork University Hospital increased from less than 7,000 cases in 1996 to nearly 15,000 in 2002. There has been a 36% increase nationally in surgical procedures for breast cancer, with an additional 500 procedures performed in 2002 compared to 1997.
Last year I announced the extension of the BreastCheck programme to counties Carlow, Kilkenny and Wexford and also the national roll out to the southern and western counties. Screening commenced in Wexford in March of this year.
The report on the development of radiation oncology services in Ireland provides the basis of Government policy in relation to the development and organisation of radiation oncology services. This report, which was developed by an expert working group under the chairmanship of Professor Donal Hollywood has received considerable international endorsement. The first phase of this programme will be the development of a network of large clinical centres in Dublin, Cork and Galway which will permit a rapid increase in patient access and also form a backbone for future service expansion.
Already, substantial progress is being made in implementing the report's recommendations. In 2004, an additional €3.5 million is being used to develop the services at the supra regional centres at University College Hospital, Galway, and Cork University Hospital. The immediate developments in the south and west will result in the provision of an additional five linear accelerators. This represents an increase of approximately 50% in linear accelerator capacity. I have provided for the appointment of an additional five consultant radiation oncologists. Recruitment for these posts is under way. We currently have ten consultant radiation oncologists nationally. This will result in a significant increase in the numbers of patients receiving radiation oncology in the short term.
In relation to other areas of cancer services, significant work is also being undertaken. Under the Ireland-Northern Ireland-NCI Cancer Consortium, awards to the value of €3.5 million are enabling Irish hospitals develop their infrastructure to enable them to carry out high quality clinical trials. Irish hospitals will be able to participate in world-class clinical trials involving the latest advances, helping to ensure that these new and effective treatments are available more readily to patients as a result of this funding.
The new national cancer strategy will target investment for cancer services over the next number of years and will make recommendations in relation to the development and organisation of services nationally. The strategy will also provide a mechanism for the development, implementation, monitoring and updating of clinical guidelines for the treatment of cancer.
