‘Significantly better’ survival rates for some cancers if going private

Survival rates for certain types of cancer are "significantly better" if patients are attending private hospitals, a report by the National Cancer Registry has found.

A summary of the full report, which is to be published on Thursday, shows marked differences in the outcomes of treatment between private and public healthcare, depending on the cancer.

For rectal, breast and prostate cancers, survival of patients being treated at private hospitals “was on average significantly better”, the analysis of records between 1994 and 2015 shows.

However, in cases of stomach cancer, survival of patients in private hospitals "averaged significantly poorer" than in the eight designated cancer centres at publicly-funded hospitals in Dublin, Cork, Waterford, Limerick and Galway.

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There are also differences in survival outcomes within the public health system.

Patients first treated or diagnosed in one of the eight designated cancer centres had “higher survival” rates overall than those seen in other public hospitals, the study concluded.

This remained the case even after researchers allowed for adjustments for patient age, gender, stage of cancer and wealth.

The report’s authors warn “cautious interpretation is needed” as the variation in treatment outcomes could, in part, reflect different referral patterns for patients considered better candidates for treatment.

“In addition, survival of patients in some non-designated public hospitals may also be high,” they added.

But the researchers say “substantial survival differences” between hospitals still remain after they allowed for differences in cancer stage, patient wealth, age and gender.

This suggests that differences “in the appropriateness or quality of treatment, or unmeasured differences in general patient health affecting suitability for treatment, are likely to be contributing to survival differences between hospital categories”.

Most private or non-designated public hospitals – other than the eight specialist centres – treat very small numbers of cancer patients annually compared to the specialist centres, the study notes.

Centralise cancer care

Prof Kerri Clough-Gorr, director of the National Cancer Registry and professor of cancer epidemiology at University College Cork, said the findings also confirm that the decision in 2007 to centralise cancer care in eight hospitals "is working".

“At the same time, we must acknowledge that centralisation has occurred against a background of other ongoing improvements in Irish cancer services, including increases in the use of appropriate cancer treatments across all hospital types and the introduction of population-based screening programmes, now covering breast, cervical and bowel cancers.

“All these initiatives have contributed to improvements in survival of Irish cancer patients but, as the centralisation programme ‘beds in’ and further expands to cover additional cancer types, the specialisation and standardisation of treatment associated with centralisation should further improve survival.

“The National Cancer Registry will continue to document these trends.”

The report authors say further work “to more fully explore and explain the findings here is needed”.

The National Cancer Registry is a public body which has been collecting information on cancer among the population since 1994. The information is used for research, education and planning of cancer services.