Cancer outcomes reflect inequality

While there have been many advances in the early diagnosis and effective treatment of cancer in recent years, these improvements in care do not always reach all sectors of society. Two recent reports have highlighted how people living in more deprived areas experience a poorer survival from cancer than those who live in more affluent parts of Ireland. Research published by the National Cancer Registry (NCR) found that breast cancer patients from the most deprived areas were about 30 per cent more likely to die from their cancer than patients from the least deprived areas, having allowed for differences in patients' age. This translated into a 75 per cent survival to five years after diagnosis in the most deprived group compared with 80 per cent in the least deprived group.

Those from more deprived backgrounds were more likely to present late with advanced stage cancers. In addition, they were more likely to present with symptoms rather than through screening and were less likely to have breast-conserving surgery. The second piece of research was presented recently at the Irish Cancer Society (ICS). Funded by the Health Research Board, the research, which was carried out at NUI Maynooth, found death rates from cancer in some of the poorest parts of Dublin were more than twice as high as rates in more affluent areas. For example a map of the results shows that, in West Dublin, cancer death rates varied from 381 per 100,000 in Blakestown North-West to 128 per 100,000 in Castleknock South-East.

Some of these disparities are due to the difficulties accessing healthcare experienced by the poorest in society. But as the NCR report noted, there is a need to identify all barriers that result in less use of healthcare. In this context, the ICS commitment to fund specific research into cancer inequalities is welcome. Healthy Ireland, the Government's plan to improve health and wellbeing nationally, must also prioritise action to improve equality in healthcare.