Progress in cancer to be welcomed, but many challenges remain

 A recently published country profile by the Organisation for Economic Co-operation and Development (OECD) for the European Cancer Inequalities Registry provided further evidence of positive trends in Ireland with regard to cancer.

It highlighted the per capita mortality for nine of the 10 most common cancers between 2011 and 2019. Overall cancer mortality in this period reduced by 14 per cent for men and 13 per cent for women.

The OECD report said Ireland’s increased five-year cancer survival rates were indicative of “high-quality care”.

For the first time, the number of patients living after an invasive cancer diagnosis had exceeded 200,000. This was the equivalent to one-in-24 people in Ireland.

In a press release for World Cancer Day (4 February) following the publication of the report, the Department of Health highlighted the extra investment made in cancer services in recent years. The implementation of the National Cancer Strategy 2017-2026 was supported by an additional €20 million in funding in 2021 and again in 2022.

“Tackling cancer is a mammoth task, but we are seeing progress, and I’m very heartened that we are reporting increased survival rates and seeing more people live longer with, and beyond, cancer,” according to Minister for Health Stephen Donnelly.

Positive developments are occurring, such as the CAR T-cell treatment programme, which recently opened in St James’s Hospital, Dublin. Also, in this issue of the Medical Independent (MI) we interview Dr Aoife Doyle about her welcome appointment as Lead Pathologist of Cervical Cytology at the National Cervical Screening Laboratory, which finally began operating in December 2022.

However, serious challenges remain. Another story in this edition of MI is about continuing capacity concerns within the area. The issue of capacity deficits has been raised repeatedly at executive management meetings of the National Cancer Control Programme. It was also raised at the HSE safety and quality committee meeting in October, with particular reference to recruitment.

HSE Chief Clinical Officer Dr Colm Henry told the meeting that “the loss of experienced staff and difficulties in recruiting new staff is impacting on services and may be adding to capacity challenges”.

Recruitment difficulties do not just apply to cancer care. It is a wider issue with which the health service has been struggling for some time, for a variety of reasons. At the recent National Health Summit in Croke Park, Mr Stephen Mulvany, acting HSE CEO, referred to staff burnout after the Covid-19 pandemic as one of the reasons for the high level of turnover across the HSE.

The delays to diagnoses and treatment caused by the pandemic have also put more pressure on already stretched services, including cancer care.

It is right to acknowledge the progress that has been achieved in cancer outcomes. But if this progress is to be maintained, there are many fundamental issues that still need to be tackled.