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Early diagnosis credited for near-total survival from some cancers after five years

Late presentation remains common for cancers affecting the head and neck, pancreas and lung

Early diagnosis is leading to better cancer outcomes, including near-total survival at five years for some forms of the disease, according to a new report from the National Cancer Registry (NCRI).

A high proportion of cancers affecting the skin (melanoma), uterus and prostate present at an early stage, resulting in five-year survival of “up to 100 per cent”, according to the NCRI annual statistical report. Early diagnosis is associated with better cancer outcomes, reduced complexity of care for patients and lower cost of care, it points out.

Cancers with a population screening programme (such as BreastCheck, BowelCheck or CervicalCheck) also experience high five-year survival when detected in early stages. In contrast late presentation remains common for cancers affecting the head and neck, pancreas and lung, with consequent poor outcomes.

Older people experience higher cancer incidence and lower survival rates compared to other age groups, the report also highlights.

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The five-year net survival for those aged 75 year or over is 46 per cent, compared with 86 per cent for the 15-44 year age group. For oesophageal, liver, pancreatic, lung and brain cancers, the five-year survival rate in those aged 75+ years is less than 15 per cent.

“Internationally it has been recognised that there are many factors underlying these findings including tumour biology, patient comorbidities which limit treatment options, poorer treatment tolerance, reduced physiological reserve, lack of representation in clinical trials and delayed diagnosis as older people may be less likely to seek and experience delays in seeking medical attention for symptoms,” said Prof Deirdre Murray, director of the NCRI.

According to the report, this figure has remained at 14 per cent in the 2016 to 2019 period. The cancers with the highest rate of emergency presentation were cancers of the brain, pancreas, liver, gallbladder/biliary tract, lung, ovary, and colon.

The negative impact of the Covid-19 pandemic on cancer services may be approaching its end, the report appears to show.

In 2020, the first year of the pandemic, the shortfall in cancer diagnoses due to Covid-19 was estimated at 10 per cent. In 2021, the shortfall was 4 per cent (7 per cent for men and 1 per cent for women). While the shortfall for 2022 was estimated to be 9 per cent, initial indications are that diagnoses have returned to expected levels.

By the end of 2021 the number of people living after a cancer diagnosis was almost 215,000 – 4.3 per cent of the population, or about one in 23 people. While this is 50 per cent higher than a decade earlier, it reflects both the increase in cancer diagnoses and ongoing improvements in cancer survival.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times