Address by Minister Micheál Martin, T.D., Minister for Health and Children at the launch of the Report ‘Cancer in Ireland, 1994 to 2002: Incidence, Mortality, Treatment and Survival’

Ladies and Gentlemen

I am very pleased to join you here this afternoon to officially launch this latest report of the National Cancer Registry‘Cancer in Ireland, 1994 to 2002: Incidence, Mortality, Treatment and Survival’. I would like to extend my sincere thanks to Dr. Harry Comber, Director of the National Cancer Registry, for inviting me here today and I would like to take the opportunity to acknowledge the significant work of the Board and those associated with the Registry since its establishment in 1991.

The work of the Registry is a major element in developing a comprehensive cancer policy. It provides a national data set essential for epidemiological and research purposes and valuable information on cancer rates.

We know from the data that:

  • Over 21,000 Irish people will develop cancer this year and 7,800 will die of the disease. The commonest cancers are those of skin, breast, colon, prostate and lung.
  • Cancer numbers are increasing by about 1.5% every year, mainly due to growth in our population.
  • Cancer causes one-quarter of all deaths in Ireland and is the largest single cause of death for the Irish population.
  • Patients with cancer accounted for over 300,000 days’stay in hospital in 1999. This was just under 10% of the total in 1999.

There was little real change in the number of cancer deaths between 1994 and 1999. The true risk of dying from cancer (allowing for the effects of population change and ageing) is decreasing by about 1% per year.

Health information is fundamental to assessing and implementing quality programmes. It provides a rational basis for the evaluation and planning of the health services. This was recognised in the National Health Strategy which highlighted information as one of the six critical frameworks for change for the successful implementation of the Strategy.

The National Health Information Strategy which will be published shortly will provide the context for future development in this area. It will demonstrate my commitment to the future development and use of high quality information as a basis for healthcare decisions.

National Cancer Registry Investment

Strengthening cancer surveillance is a key element of my Department’s overall approach to cancer policy and services. Earlier this year I allocated almost €180,000 in revenue funding to the Registry for this purpose as follows:

  • €68,000 to enable the appointment of two new full-time registration officers to improve the collection of data.
  • €42,000 for a one-year “electronic data collection project” to identify potential sources of data and to integrate this data into the current database of the Registry.
  • €69,000 for the purchase of a Geodirectory. This will enable the Registry to establish precise references between different areas when examining cancer incidents.

In recognition of the further need to develop the cancer surveillance capabilities of the Registry, I am pleased to announce here today the allocation of €73,000 ongoing revenue funding to the Registry for the appointment of a permanent full-time Epidemiologist to work on patterns of care and health services research. This will bring the total allocation of the Registry in 2003 to €1.76million.

The importance of cancer surveillance in the management of chronic disease is increasingly being recognised. Cancer surveillance can provide a quantitative portrait of cancer and its determinants in a defined population. It will allow for the production of timely, reliable and relevant information on cancer.

This will enable health care providers and policy makers to effectively plan, resource and manage cancer control activities. This will help ensure that cancer control programmes are planned and delivered on the basis of their impact on overall public health as well as on the health of those who develop cancer. I look forward to surveillance of cancer being an early priority of chronic disease surveillance by the Health Information and Quality Authority.


National Cancer Strategy Investment

Targeted strategies such as the Cancer Strategy need to be informed by the timely and focused analysis of data. The work of the National Cancer Registry provides an essential contribution to informing the ongoing implementation of the National Cancer Strategy. Major developments in the treatment and care of patients with cancer have taken place since the launch in November 1996 of the National Cancer Strategy.

  • Since 1997, a cumulative additional investment of approximately€400 million has been invested in the development of cancer services.
  • This level of funding is a clear indication of this Government’s continued commitment to the development of co-ordinated and patient-focussed cancer treatment in line with the recommendations of the National Cancer Strategy.
  • This investment has enabled the funding of 87 additional consultant posts in key areas such as Medical Oncology, Radiology, Palliative Care, Histopathology, and Haematology, together with support staff.
  • Last Thursday I officially published the Report on the Development of Radiation Oncology Services in Ireland. The Government has accepted the recommendations of this Report and agrees that a major programme is now required to rapidly develop clinical radiation oncology services to modern standards. I wish to acknowledge the input of the Registry and the participation of its Director, Dr. Harry Comber, in this most authoritative analysis on radiation therapy.
  • Furthermore, the Government has agreed that the first phase of such a new programme should be the development of a clinical network of large centres in Dublin, Cork and Galway. These centres will collectively have the staff and treatment infrastructure to permit a rapid increase in patient access to appropriate radiation therapy and will form the ‘backbone’ of the future service expansion.
  • I agree with the Report’s conclusion that this is the best model to enable the rapid development of radiation oncology and I have now set out a detailed programme of development and investment in these services on that basis.
  • I am looking forward to hosting the Second All-Ireland Cancer Conference next Monday 20 October in Cork. The conference, which has been organised by Dr. Comber, is multi-disciplinary and will offer experts in the field the opportunity to participate in a forum for the exchange of views and ideas for advancing cancer research and practice. This is a follow-up to the inaugural conference on the establishment of the Ireland-Northern Ireland-NCI Cancer Consortium in Belfast in 1999.
  • The principal objective of the Consortium is to enhance the capacity of our cancer services to improve the lives of cancer patients on the island. As a result of the NCI initiative the Department, since 2001 has invested in supporting hospitals to develop their infrastructure to enable them to participate in clinical trials. The NCI initiative has challenged the Department to support these initiatives and the feedback from participants and the Health Research Board is very positive.
  • The All-Ireland Cancer Statistics Report was released under this initiative. This involved a first-time co-ordination of cancer statistics for the island’s entire population from the cancer registries of Ireland and Northern Ireland. I understand that Mr. Joe Campo from Washington State Cancer Registry has begun his one-year cancer research fellowship and that he will produce the Second All-Ireland Cancer Report.

Health Promotion

These actions have been complemented by initiatives in the field of health promotion. The Health Promotion Unit of my Department supports an extensive range of initiatives that have an impact on the levels of knowledge and awareness of the risk factors associated with many cancers.

The National Health Strategy sets out that actions on major lifestyle factors targeted in the National Cancer and Health Promotion Strategies will be enhanced.

In pursuit of this objective, as you are all aware, I am introducing a ban on smoking in the workplace from January 2003. This ban follows the Report on the Health Effects of Environmental Tobacco Smoke in the workplace carried out by the Office of Tobacco Control and the Health and Safety Authority.

This ban is an effort to protect employees and the public, including children from exposure to the harmful effects of toxic tobacco smoke. This is an important step in tackling the heavy burden that cancer places on our health service and on society as a whole. Cigarette smoking is the leading etiologic factor for lung cancer. It follows that the single most significant measure to prevent lung cancer is to reduce the use of tobacco.

The statistics in relation to lung cancer published in today’s report, reaffirm the need for full and complete implementation of this ban. In 2002 there were 1564 new cases of lung cancer. This represents a 3% increase overall in the incidence of lung cancer since 1994. In that same year 1404 people died from lung cancer. Despite spectacular medical advances in the last 50 years, lung cancer causes more deaths than any other cancer. Overall, it remains the leading cause of cancer death.

Future Developments

In relation to the future development of cancer services in Ireland the National Cancer Forum, of which Dr. Comber is a member is currently developing a new Cancer Strategy. This Strategy will build on the progress to date and set out the key areas for future investment. It is important that this Strategy addresses all aspects of cancer services including the need for high quality information and performance indicators.

Protocols for the care and treatment of cancer patients, information requirements, audit and evaluation of our services, genetics and further screening programmes are all important component parts of the appropriate future development of cancer policy. The new Cancer Strategy will address all of these issues.

I welcome this most recent Report of the National Cancer Registry. It marks a significant milestone in cancer surveillance in Ireland and will, I am sure, prove invaluable to my Department and the National Cancer Forum in their deliberations. Once again, I would like to extend my thanks to the National Cancer Registry for inviting me to launch this report and I wish the Registry well with its future endeavours.Thank you.