We must plan for the needs of cancer survivors

Professor Kerri Clough-Gorr, Director of the National Cancer Registry has urged that with improving cancer outcomes, we must go beyond our current capabilities of reporting of incidence, initial treatments and survival to better understand the patient experience, including quality of life, disease progression and recurrence and long term treatments.

Professor Kerri Clough-Gorr
Professor Kerri Clough-Gorr

“Planning for the long-term support and follow-up needs of cancer survivors is an important health priority, as recognised by the recently published National Cancer Strategy 2017-2026,” she said, writing in the 2018 National Cancer Registry report.

“Currently we estimate that about 173,000 cancer survivors previously diagnosed with an invasive cancer were alive at the end of 2016, equivalent to almost 4% of the Irish population, excluding non-melanoma skin cancers (NMSC).

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“Based on demographic changes alone, numbers of cancers (excluding NMSC) are projected to increase to 24,160 in men (approximately a 110% increase in case-numbers compared with 2015) and to 18,840 in women (approximately an 85% increase) by 2045 – or 43,000 total, a doubling of numbers overall.

“However, an overview of projections based on different sets of assumptions suggests that the overall increase by 2045 could be more modest (approximately a 50% increase across both sexes) if recent trends in some cancers (for example, declines in male lung and prostate cancer rates) continue. Nevertheless, this is likely to require a sustained and expanded focus on prevention of cancer, through appropriate interventions and education.

“Overall, the message of this year’s report is that population growth (and ageing) will continue to generate a major increase in numbers of cancer cases diagnosed annually – potentially a doubling of numbers between 2015 and 2045 if current cancer rates continue to apply – and this in turn, combined with survival improvements, will greatly increase the numbers of cancer survivors.

Over the years 2016-2018, about 41,075 new cancer cases were diagnosed each year on average in the Republic.

This was made up of about 22,640 invasive cancers other than non-melanoma skin cancers, 10,815 non-melanoma skin cancers and 7,620 non-invasive tumours.

The report says that the figures “equate to an average of 112 people being diagnosed each and every day; in practice cancers are usually diagnosed during the working week so the daily number on any given weekday is substantially higher.”

Taking age and population size into account, the overall risk of cancer at an individual level appears not to be increasing in recent years, although there are some exceptions for specific cancers.

Excluding NMSC and non-invasive tumours, the four most common cancers diagnosed in men in Ireland were prostate cancer (29 per cent), bowel cancer (14 per cent), lung cancer (12 per cent) and melanoma (4 per cent)

For women, it was breast cancer (30 per cent), lung cancer (11 per cent), bowel cancer (11 per cent) and melanoma (6 per cent).

Over the years 2013-2015, an average of 8,875 people lost their life due to invasive cancer (or 9,084 due to any tumour), or about one person dying from cancer every hour of the day.

The four most common cancers causing death were lung cancer (21 per cent), bowel cancer (11 per cent), breast cancer (8 per cent) and prostate cancer (6 per cent).

For men it was lung cancer (23 per cent), bowel cancer (13per cent), prostate cancer (11 per cent) and pancreas (6 per cent) For women, it was lung cancer (19 per cent), breast cancer (17 per cent), bowel cancer (10 per cent) and ovarian cancer (6 per cent).