New National Cancer Strategy to cost €100 million a year

The new National Cancer Strategy, 2017 – 2026 will cost €100 million a year over the next 10 years, according to Health Minister, Simon Harris, who said he would seek the funding on an incremental basis as part of the budget estimates process. Maureen Browne reports.

The new strategy is focussed on preventing cancer across our population, diagnosing cancer early, providing optimal care to patients and maximising their quality of life.

The number of cases of cancer in Ireland is expected to increase by 50% in men and 40% in women by 2025, and to nearly double by 2040. This is mainly due to an increasing and an aging population.

The percentage of deaths attributable to cancer has risen from 20% in the 1980s to over 30% at present. At the same time, there are over 150,000 cancer survivors in Ireland now and a greater focus on the increasing numbers living with and beyond cancer is required.

While overall cancer five-year survival rates in Ireland have improved from 45 per cent to 60 per cent since the mid-1990s, our current survival rates still fall below the median value for almost all the common cancers compiled by the OECD for 34 countries.

Launching the strategy, the Minister said, “This strategy sets an ambitious target and we aim to be in the top quartile of European countries for cancer survival by the end of the strategy period. Cancer prevention offers the most cost-effective, long-term approach for cancer control. In fact, 30-40% of cancers are avoidable through improved diet, more exercise, reduced alcohol intake, limited exposure to ultraviolet radiation and of course not smoking.”

Key recommendations in the Strategy include:

  • HSE’s National Cancer Control Programme to develop a cancer prevention function in conjunction with the broader Healthy Ireland initiative.
  • Appropriate endoscopy capacity to be provided in hospitals to allow for the expansion of BowelScreen to all aged 55-74 by end-2021.
  • Development of a plan to enhance the care pathways between primary and secondary care for specific cancers.
  • Improve GP access to diagnostics and provide GPs with early referral criteria. HSE’s National Cancer Control Programme to develop referral criteria to ensure that GPs have direct access to cancer diagnostics within agreed timelines
  • The appointment of a National Lead for Cancer Molecular Diagnostics for solid and liquid malignancies.
  • An age appropriate facility to be designated for adolescents and young adults with cancer within the new children’s hospital.
  • Links between cancer services to be strengthened, facilitated by the appointment of a National Clinical Lead in Geriatric Oncology.
  • Cancer consultants and Advanced Nurse Practitioners to have protected time to pursue research interests in their new posts.
  • Appointment of a National Clinical Lead for Cancer Nursing to support practice and research.

The HSE’s National Cancer Control Programme is to develop, publish and monitor a programme of national quality healthcare indicators for cancer care, in line with international standards.

The new strategy also aims to ensure that patients receive the required care, (diagnostics, surgery, radiation, etc.), in a timely fashion, from an expert clinical team in the optimal location.

It recommends the expansion of radiation and medical oncology, as well as the concentration of surgical services in the designated centres.

The strategy builds on progress made to date by supporting the key role of designated cancer centres in cancer treatment. The centralisation of surgical services for more cancers will be progressed to ensure that optimal treatment is provided and outcomes are improved.   Radiation oncology will also be further developed. Multidisciplinary team working will be used to a greater extent

A major focus will be placed on workforce planning. An early emphasis will be placed on addressing gaps in areas such as nursing, medical oncology and urology, as well as other health and social care professionals.

The number of cases of cancer in Ireland is expected to increase by 50% in men and 40% in women by 2025, and to nearly double by 2040.

Rare cancers, defined as those with an annual incidence of less than six cases per 100,000, comprise about 20% of all cancers, with approximately 5,200 new cases annually. The strategy says there is a need for clear care pathways for the diagnosis and treatment of patients who have rare cancers, with particular emphasis on timely treatment planning at national MDT level, involving subspecialty expertise in diagnosis and treatment and with linkages to international centres of excellence for specialist advice and intervention.

Technological advances are resulting in improvements in cancer detection, treatment and survival. Genomics, cancer genetics and molecular diagnostics provide the potential for improved diagnosis and personalised medicine. The Strategy outlines development to be made in these areas.

It says the growth in cancer incidence and the number of patients on active treatment, together with new drugs, will increase the volume and complexity of medical oncology The NCCP will examine the model of care for patients requiring oral anti-cancer medications.

Approximately 200 children and young adolescents (0-16 years of age) are diagnosed with cancer each year Cancer services for children and adolescents/young adults are an area of focus in the strategy. The new children’s hospital will provide the opportunity to establish an age-appropriate facility for adolescents and young adults with cancer.

The centralisation of surgical services for more cancers will be progressed to ensure that optimal treatment is provided and outcomes are improved.

Patient involvement in policy and service delivery will be promoted at local, regional and national levels. A Cancer Patient Advisory Committee will be established.

The current figure of about 150,000 cancer survivors will grow as cancer incidence grows and treatments improve. The strategy says there is a need to develop and implement survivorship programmes for patients with cancer. The emphasis should be on maximising the quality of life.

Patients will also be offered Patient Treatment and Summary Care Plans as part of their support that will guide them towards self-management of their care.

The recommendations of the strategy will be reviewed towards the end of 2021, at the mid-point of the Strategy period, to ensure that the aims and direction continue to be appropriate.

Tony O’Brien, Director General of the HSE, said: “In welcoming the third cancer strategy I am mindful of the enormous progress made under the previous strategies, evidenced by significantly improved survival rates. The HSE is fully committed to achieving similar levels of progress over the next decade. Our focus will be evolving our services,  developing new initiatives, enhancing clinical research and to further improve quality, treatment outcomes and survivorship for Irish cancer patients.”

The new National Cancer Strategy 2017 – 2026 can be found on the Department’s website – http://health.gov.ie/blog/publications/national-cancer-strategy-2017-2026.