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Early diagnosis associated with better cancer outcomes

 A woman smiling.

“This year, the National Cancer Registry Ireland (NCRI) report emphasises some major themes that are core to planning for cancer control,” according to Professor Deirdre Murray, Director of the National Cancer Registry of Ireland (NCRI), pictured.

“Life expectancy in Ireland is among the highest in Europe and we present the outcomes for cancer in older people, which will hopefully form a benchmark for policy makers and service planners in their work. Equally, we highlight the benefits of early diagnosis on cancer outcomes by cancer type and finally, we report on cancers presenting as an emergency, both key indicators of cancer control.”

The report - Cancer in Ireland 1994 to 2021 -  is an analysis of nationally collated data revealing the status of cancer in Ireland including statistics on cancer incidence, mortality, and survival. It focuses on the impact of age and stage at diagnosis on cancer outcomes.

Welcoming the report, Dr Jerome Coffey, Chair of the NCRI Board said that “the Annual Statistical Report is the most important registry output for everybody involved in organising and delivering cancer care."

"In addition to the key findings and themes,  it is important to focus on the increase in total cancer cases over time, reflecting changes in the size and age profile of the population, and to ensure adequate healthcare capacity to meet this challenge.”

Key findings show that early diagnosis is associated with better cancer outcomes, reduced complexity of care for patients and lower cost of cancer care. A high proportion of some cancers (e.g. melanoma, uterine and prostate cancers) present at an early stage with consequent 5-year net survival of up to 100% in many cases. Cancers with a population screening programme also experience high 5-year net survival when detected in early stages. However, late presentation (stage IV) remains common for some other cancers (e.g. head and neck, pancreatic and lung cancers) with consequent poorer outcomes.

Older people experience higher cancer incidence and lower survival rates compared to other age groups. Five-year net survival for those aged over-75 is 46%, compared with 86% for those in the 15 to 44 year age group. Internationally, it has been shown that many factors underlie these findings including delayed diagnosis as older people may present later for medical attention of symptoms. Patients may also have other serious illnesses which limit treatment options; there may be poorer treatment tolerance, reduced physiological reserve and lack of representation in clinical trials.

The number of invasive cancers (excluding non-melanoma skin cancers) presenting as an emergency was estimated at 14% from 2016 to 2019, down almost 6% since 2002. This fall from 20% to 14% was observed between 2002 and 2009, after which no further reduction was evident. Unfortunately, emergency presentation is associated with more advanced stages and therefore limited treatment options and poorer survival outcomes.

More complete data on the impact of the COVID-19 pandemic on cancer diagnoses in 2021 indicates that the pandemic resulted in a 4% reduction in cancer diagnoses compared to what was expected that year. Early indicators suggest a return to expected rates of cancer diagnoses in 2022.

Find the 'Cancer in Ireland 1994 to 2021' report