Michael Noonan made clear, very shortly after he was appointed Minister for Health, that improving cancer detection and treatment services would be high on his ministerial agenda. He may have allowed his early enthusiasm to carry him away a little when he said, in January 1995, that he hoped to have a policy on cancer developed in the Department of Health in 12 weeks. Now, nearly two years later, he has begun to deliver on his word, although some well-placed leaks in recent months have indicated what some of the plans contained.
With annual deaths from cancer in this State now rising towards 8,000, few people can be unaware of the threat which the disease presents, or the distress which it can cause. But the great fear of cancer, which, only a few decades ago amounted to something approaching a taboo, has diminished as treatments improved and as people began to recognise that a diagnosis of cancer need not always mean an imminent death sentence. But as more people more openly-sought treatment for the disease in its many forms, and as the number seeking screening for early detection rose, it became obvious to many, including the Minister, that facilities for both screening and treatment were very unevenly distributed.
Many people have discovered that, on top of the distress caused by the disease, further distress was caused particularly to those living away from the main centres of population by the distances they had to travel to avail of such services as were available. Mr Noonan's proposals for the regionalisation of service organisation should do much to alleviate this latter distress for most patients. The proposed national cancer forum should, provided that the right experts are appointed to it (including the consumer representatives), ensure a continuing expert monitor of both local and national facilities and the treatments they offer.
Screening programmes for breast and cervical cancer, targeted nation-wide at women in those age groups where the risk is greatest and early detection rates are likely to be highest, will be widely welcomed as will the commitment to provide adequate back-up diagnostic laboratory staff and services. As has been conclusively shown in the recent past, screening programmes which take weeks or even months to produce their results can be stressfully counterproductive.
And either the Minister or his national forum should keep their eyes open for other effective screening techniques as they become available. Early detection leads to more effective treatment.
But, as the incidence of cancer rises, prevention must surely be the ultimate objective of any national cancer policy. Environmental substances and certain behaviours (such as smoking) are well known to lead to cancers of various kinds. Not all the cancer-causing substances or behaviours can be eliminated, but better and well-targeted health education offers the best prospect currently of reducing significantly the number of cases coming forward for both screening and treatment. This, and other environmental and nutritional measures to reduce the prevalence of cancer in the community, might merit a greater emphasis than seems to have been accorded to prevention in the current policy, as published.