Poorest are 40% more likely to die from cancer than more affluent, report says

Ireland needs to do more to tackle inequalities in cancer outcomes, says OECD

Ireland needs to do more to tackle inequalities in cancer outcomes, according to the OECD, with patients from highly deprived backgrounds 40 per cent more likely to die from the disease than the most affluent.

While significant progress has been made in reducing cancer-related risk factors, the report lists income and educational levels as factors in inequality in screening take-up and smoking rates.

Smoking rates reach 18 per cent among those on the lowest income level, compared with 7 per cent for people with the highest. Some 17 per cent of Irish people with the lowest level of educational attainment smoke, compared with 9 per cent of those with higher levels.

Women with high educational attainment are far more likely to attend screening (72 per cent for breast cancer and 69 per cent for cervical cancer) than women with low educational attainment (56 per cent and 29 per cent, respectively).


Waiting lists are a significant issue in Ireland, especially waiting times to receive a diagnosis, the OECD points out in a country profile prepared for the European Cancer Inequalities Registry.

While deaths from cancer in Ireland are marginally above the EU average, this is attributed in part to increasing life expectancy. For nine of the 10 most common causes of death from cancer, the death rate has been decreasing over time.

Progress is being made on reducing smoking and alcohol consumption, the report says, with Ireland among the bottom quarter in the EU for smoking and slightly above average for alcohol consumption.

Someone in the EU is diagnosed with cancer every 12 seconds, with 2.6 million cases recorded across the bloc in 2020. Cancer is responsible for 1.2 million deaths annually, compared with 1.1 million for Covid-19. Mortality in Europe is 75 per cent higher among men, though the gender gap in Ireland is much smaller.

Survival rates in Ireland are slightly above the EU average for many of the most common cancers and slightly behind for breast cancer. “These trends are indicative of high-quality care. However, timeliness of access – especially pre-diagnosis – remains a problem for patients,” the OECD says.

There was an estimated 631 new cancer cases per 100,000 women in Ireland in 2020 and 822 per 100,000 men, higher than the predicted EU average of 484 per 100,000 women and 686 per 100,000 men.

While child cancers are relatively rare by EU standards, Irish women have the fourth-highest rate of melanoma in the EU, and stomach cancer rates are well above average.

Cancer is the most common cause of death in Ireland, accounting for 31 per cent of deaths, up from 20 per cent in the 1980s. Mortality rates have dropped 14 per cent for men and 13 per cent for women since 2011. And while mortality rates are above the EU average, they are falling faster than elsewhere.

The main exception is liver cancer, where mortality has increased 24 per cent since 2011.

The report estimates smoking is responsible for 2,900 cancer deaths each year, or 13 per cent of all cancer deaths. While Ireland has low smoking rates relative to other EU states, it has the highest rates of vaping; 5 per cent of Irish people aged 15 and over vape, more than double the EU average of 2.3 per cent.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times