People living in the most deprived areas have a 28 per cent higher risk of dying from cancer compared to those living in the most affluent parts of the State, according to a new report.
The difference in five-year survival rates remains sizeable even after adjusting for age, gender and cancer types, according to National Cancer Registry Ireland (NCRI).
Although cancer incidence rates have fallen and survival rates have improved over time across the majority of cancers and for all sectors of society, there is no evidence of any reduction in disparities between those living in the least and the most deprived areas, it says.
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The incidence of stomach, lung and cervical cancers is higher in more deprived areas, while more affluent areas have a higher incidence of breast, prostate, and melanoma and non-melanoma skin cancer.
Those in the most deprived areas were most likely to present late with breast and prostate cancers, but there were no disparities in stage of presentation for lung and colorectal cancers.
The incidence of cancer among men in the most deprived areas is 7 per cent higher compared to those in areas with least deprivation. For women, the difference is 5 per cent, according to the NCRI report.
“These important data underline the known links between socioeconomic deprivation and cancer incidence and survival, with no major reductions in disparities between groups over the time periods examined,” chair of the NCRI board Dr Jerome Coffey said. “Prevention, screening and early diagnosis are major elements of the National Cancer Strategy 2017-2026 and will have to remain as priorities in subsequent strategies.”
A range of potential factors may contribute to such disparities, the NCRI says, including differences in general health, exposure to particular risk factors, health-seeking behaviour that can influence early detection, access to healthcare, or other factors that may be linked to socioeconomic or geographic factors.
Tackling inequalities in cancer outcomes is emerging as a new priority in health across the Europe. An OECD report on Ireland’s performance in tackling cancer, to be published on Wednesday, is expected to make similar findings to that of the NCRI about differences in incidence and outcomes across the socioeconomic divide.
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According to the Irish Cancer Society, opportunities to detect cancer early are being missed and patients and their families are “paying the price”. The impact is being felt the greatest by those on lower incomes who cannot afford to skip the public queue by paying for tests privately, chief executive Averil Power will tell the Oireachtas health committee.
“Our central concern is that, in Ireland today, people are not being given the best chance of surviving cancer and having a good quality of life. The earlier cancer is caught, the easier it is to treat and the greater the person’s chances are of surviving the disease.”
The five-year survival rate for colorectal cancer is 95 per cent if diagnosed at stage I but falls to 10 per cent at stage IV, Ms Power will point out, while for breast cancer the survival rate falls from 94 per cent to 19 per cent when diagnosed late.
“Early diagnosis can literally be the difference between life and death,” she will tell the committee. However, more than 200,000 people are waiting for a vital radiology scan, 150,000 of them for longer than three months, despite the target in Sláintecare being just 10 days.