OPINION: Ireland has the worst record in western Europe for treating bowel cancer. Now, in an effort to force the Government to allocate funds, the Cancer Society is putting up €1m for a national screening programme
AT A TIME of a major economic crisis and recession and when a significant number of other charities are competing and struggling to maintain funding from the State, it is a major departure that the Irish Cancer Society should be making an offer of €1 million to the State towards the roll-out of a national bowel cancer screening programme.
This funding offer is being made in an effort to obtain an enduring commitment from the State that they will deliver on this programme for men and women aged between 55 and 74 years. This programme will reduce the incidence of bowel cancer and save lives from this common disease.
Needless to say, the Irish Cancer Society is not usually in the business of offering precious funds raised through public contributions to the State, but on this occasion we do not have any choice. We believe that unless there is a clear driving force, it is easier for the Government, especially in the current climate, not to do anything. We also believe we have a duty of care to the people of Ireland to drive the roll-out of this programme, which will be one of the most effective public health interventions in the history of the Irish healthcare system.
The latest data from the National Cancer Registry of Ireland shows that 2,174 new cases of bowel cancer were diagnosed in 2007. This is predicted to increase to about 3,300 new cases by 2020. Bowel cancer currently represents 9 per cent of all invasive cancers, while 60 per cent of those are diagnosed at stage three and the more advanced stage four, when it is more difficult to treat.
Ireland has the highest mortality rate for bowel cancer in western Europe and the fourth-highest rate among men worldwide – more than 900 people die from bowel cancer here every year.
When the Strategy for Cancer Control in Irelandwas published by the Department of Health National Cancer Forum in June 2006, it set out its vision as follows: Ireland will have a system of cancer control which will reduce our cancer incidence, morbidity and mortality rates relative to other EU countries by 2015. Irish people will know and practise health- promoting and cancer-preventing behaviours and will have increased awareness of and access to cancer detection and screening.
The strategy also dictated that a colo-rectal cancer programme should be established to encompass population screening, high-risk screening and necessary development in symptomatic colo-rectal cancer services. A similar commitment was made to roll out a cervical screening programme 20 years ago which was only delivered in September 2008, while our national breast screening programme, BreastCheck, has only just been rolled out nationally after it was first set up in 2000.
Last month, the National Cancer Screening Service published recommendations for a colo-rectal cancer screening programme in Ireland and Hiqa, the Health Information and Quality Authority, published a health technology assessment of a population-based colo-rectal cancer screening programme in Ireland. The Irish Cancer Society welcomed the publication of both reports which categorically concluded that a well-organised colo-rectal screening programme would reduce the incidence and mortality of bowel cancer.
The cancer screening service, which already delivers the BreastCheck and CervicalCheck programmes, has said that colo-rectal cancer screening is the most clinically effective and cost-effective form of cancer screening.
So can we wait until Government finances recover? No. The consequences are too serious such is the gravity of the bowel cancer here.
The Irish Cancer Society has already been on the front line in promoting bowel cancer awareness, educating people on the warning signs and encouraging them to visit their GP and discuss screening in the absence of a national programme. We have also been on the front line in drawing national attention to the long waiting lists that exist for colonoscopies, the most accurate test for diagnosing colo-rectal cancer.
In November 2008, we ran a public- awareness campaign to highlight that some patients were waiting up to nine months for a colonoscopy. We urged patients who were waiting for a colonoscopy for more than six weeks to take action by contacting their GP to see if they can schedule the procedure as soon as possible. We also advised patients that if they were waiting for longer than three months to contact the National Treatment Purchase Fund to discuss referral for a colonoscopy to a private hospital free of charge.
As a result of our campaign, by early 2009, we were welcoming significant improvements in waiting times for colonoscopies in certain hospitals. However, we remain concerned about the number of patients waiting an unacceptably long time for this crucial test, with 800 patients across the country currently waiting more than three months.
Our priority rests with the roll-out of a well- organised systematic population-based colo- rectal screening programme. All evidence points to the urgent need for such a programme which will save 330 lives a year because the cancer will be detected at a stage that it can be treated effectively. A screening programme will also prevent a further 320 people from developing bowel cancer.
We are offering €1 million over two years to get this screening programme up and running. We are making this offer from this December when the 2010 budget will be announced and when we expect State funding for bowel cancer screening to be included in the estimates.
We will offer more in year three and four, depending on the success of fundraising. We will not part with any money until we are confident that the colo-rectal cancer screening programme in Ireland will meet the highest possible standards. We will also engage with HIQA which has been asked by the Minister for Health to design a proposal for the roll-out of a national bowel cancer screening programme, a programme that can be delivered within existing resources, if that is possible, by this September.
My personal and professional support for this initiative is born out of the principal that colo- rectal cancer screening is a basic healthcare right that saves lives. The Irish Cancer Society owes it to the people of Ireland to ensure that our Government does not renege on its duty. We will hold our Government to account.
Bill McCabe is chairman of the Irish Cancer Society.