CANCER IS now the most common cause of death in the Republic. The incidence of the disease is expected to increase by 45 per cent between 2010 and 2020, primarily because of our ageing population. Some one in three of us will be diagnosed with cancer at some point in our lives.
The publication yesterday of the first “Atlas of Cancer in Ireland” by the National Cancer Registry, is another step forward in helping us understand the epidemiology of cancer here. And while there is a geographic variation in the occurrence of some cancers in the Republic, the report does not identify any particular “blackspots” that might trigger regional alarm.
Nonetheless, a number of patterns emerge from this analysis of cancers in Ireland between 1994 and 2003. In general, there is a higher incidence around our two largest cities, Dublin and Cork. For individual cancers, more specific patterns were noted: stomach cancer showed one of the strongest patterns, with one cluster in the northeast of the country and another in south Donegal. Cancer of the cervix in women is most common around Dublin and in a broad band down the eastern side of the country. And while lung cancer incidence is high in Cork and Dublin, significantly the areas of highest incidence are in deprived areas in both cities.
All cancer types analysed show some association with deprivation. It is just one of the socioeconomic differences influencing incidence; others include occupation, education and income. The fact that certain lifestyle factors linked to cancer, like smoking and poor diet, are associated with poverty undoubtedly contributes to the observed associations. Other reasons for variation in incidence include geographical exposure to risk factors and variable access to screening and cancer services.
Geographic variation in cancer numbers does not mean that the location itself causes cancer. But it is a reason to examine health service access and utilisation and to look for possible urban/rural variations in exposure to cancer risk factors.
Whatever the reason for geographic variation, many factors are potentially modifiable. For this impressive National Cancer Registry report to have maximum impact it must trigger a renewed effort to tackle issues such as smoking, obesity and alcohol intake. And while much is being done through the cancer control programme to standardise access to screening and cancer services, addressing specific risk factors related to poverty and deprivation must be a priority.