The publication of the first five-year report from the National Cancer Registry has provided us with a comprehensive review of cancer services in the State.
While it is encouraging to read that there has been no overall increase in the incidence of cancer between 1994 and 1998, the finding that there has been no reduction in deaths from a disease that kills one in four of us is not good news.
But it is in the sections of the report which deal with treatment and survival that the most disturbing statistics are to be found. Many people with cancer of the lung, stomach and the blood are not receiving cancer specific treatment. This is particularly true of the elderly. Where you live is also a factor in determining treatment, especially where access to radiotherapy is concerned. And whether your cancer treatment is planned on a scientific basis appears to be a lottery.
Take lung cancer as an example. Only 10 per cent of people with the disease are alive five years after diagnosis. Only 50 per cent of cases receive chemotherapy, radiotherapy or surgery. If you live on the western seaboard you are more likely to be denied radiotherapy. And eight out of 10 people aged 80 and over will receive no direct treatment for their lung cancer.
These statistics echo the sentiments expressed by leading cancer specialists at the First All Ireland Lung Cancer conference late last year, when lung cancer treatment was described as the "cinderella" of the health service. According to delegates, because lung cancer is self-inflicted, largely through smoking, and is a disease of lower socio-economic groups, it has not received the funding and priority accorded to other diseases. If nothing else, the disturbing findings on lung cancer should prompt the Minister for Health to implement his anti-tobacco legislation in full, especially the ban on smoking in public places.
There are important lessons to be learnt from yesterdays report. The lack of nationally agreed cancer treatment protocols must be addressed; their application must be audited and monitored to ensure equal treatment for all. Access to treatment must be equitable, whether on geographical considerations or based on age. And if rationing is to be a part of our health service, it must follow a full and open public debate. Transparency and accountability must form the cornerstone of our health system.
The Government is committed to a review of the 1996 National Cancer Strategy. Five years on and prompted by yesterday's report, a review is no longer sufficient. Nothing less than a new and comprehensive strategy for cancer care in the State will suffice.