Ireland’s midwest has lowest survival rate for common cancers, report finds

Cancer registry’s annual report examined variation in incidence and survival over a 10-year period

The National Cancer Registry of Ireland's annual report for 2020-2022 states that the geographic comparisons should be interpreted with “certain caveats”. Photograph: iStock
The National Cancer Registry of Ireland's annual report for 2020-2022 states that the geographic comparisons should be interpreted with “certain caveats”. Photograph: iStock

The midwest of Ireland has the lowest five-year survival rate for some of the most common cancers compared to the other health regions around the country, a new report has found.

On Tuesday, the National Cancer Registry of Ireland (NCRI) published its annual report for 2020-2022, which also examined variation in cancer incidence and survival across new health regions over a 10-year period.

For colorectal cancer in Ireland overall, five-year net survival was 63.5 per cent for cases diagnosed during 2009-2018. Five of the six health regions had a similar survival rate, except for the midwest (MW) region, which had a survival rate of 59.4 per cent

For lung cancer in Ireland overall, five-year net survival was 20.8 per cent for cases diagnosed during 2009-2018. But this was only 16.1 per cent in the MW - the region which covers Clare, Limerick, and North Tipperary.

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Similarly for female breast cancer, five-year net survival was 85.1 per cent for cases diagnosed during this period, but this figure was 80.1 per cent for the MW.

For prostate cancer, the MW also had the lowest survival rate, though the NCRI also highlighted a low rate in the Dublin and North East area.

However, the report states that geographic comparisons should be interpreted with “certain caveats”. The registry said late-stage diagnosis and concurrent illness result in poorer survival, adding that the figures do not adjust for stage, comorbidities, cancer case-mix and socioeconomic indicators which vary across regions.

Prof Deirdre Murray, director of NCRI, and professor of epidemiology at University College Cork, said in short it was not clear why the midwest had lower survival rates.

“An educated guess would be that we know the midwest would have the highest portion of people who are extremely disadvantaged. People in poverty are less likely to go for screening, less likely to go early for treatment of symptoms, more likely to have multiple illnesses, which often means certain treatment is curtailed,” she said

“We need to look indepth at these factors to look at what the highest influence is.”

In all, an average of 44,073 cancers or related tumours were diagnosed each year in the period 2020-2022. Some 23 per cent of all registered cancers were non-melanoma skin cancers (NMSC), which are rarely fatal. The majority of cases (24,200) were potentially life-changing invasive cancers requiring extensive treatment.

On average 9,800 people died each year from cancer during 2020-2022, with one in five deaths due to lung cancer.

Excluding NMSC, prostate and female breast cancer were the most commonly diagnosed invasive cancers overall, and each comprised almost one-third of all invasive cancers in men and women respectively during the period 2020-2022.

Survival rates
Source: The National Cancer Registry

Colorectal or bowel cancer, lung cancer, melanoma of skin, and head and neck cancer were the second, third, fourth and fifth most common cancers in males, respectively.

Lung cancer, colorectal cancer, melanoma of skin, and uterine cancer were the other most common cancers in females, respectively

In males, the most common causes of cancer deaths after lung cancer were: cancer of the prostate, colorectal, pancreas and oesophagus.

In females, the most common causes of cancer deaths after lung cancer were: cancer of the breast, colorectal, ovary and pancreas.

Prof Murray said while geographic variation “must always be interpreted with care these data can point to important opportunities for improvement across cancer care from prevention, early diagnosis, and screening, to access to services and treatment”.

Dr Robert O’Connor, chair of the NCRI board, said the findings reveals “critical insights” into regional health outcomes.

“The findings underscore the continued need for targeted, strategic investments in cancer research, prevention, treatment, and post-treatment care to equitably maximise patient outcomes and community health.”

Shauna Bowers

Shauna Bowers

Shauna Bowers is Health Correspondent of The Irish Times