Ireland at or above EU level for cancer care but 'there's things to improve,' Cork oncologist says

Improved infrastructure, quicker access to novel drugs, and a better uptake of screening are the main things Ireland could improve on in order to achieve better cancer outcomes, a Cork oncologist has said.

It comes as the European Commission’s country cancer profile 2025 report, which compares Ireland’s performance in several areas to other EU countries, was published recently. Consultant medical oncologist in Cork University Hospital, Richard Bambury, told there was good and bad highlighted in the report.

“Overall the report is relatively positive,” Dr Bambury said. “Ireland is at or above level of most European countries in terms of cancer care, treatment and outcomes.

“The high instance of cancer diagnosis in Ireland compared to the European average might be due to an ageing population,” Dr Bambury continued.

“Our life expectancy is higher than many other countries and one of the main risk factors for cancer is age.

“As people get older, they are more likely to get cancer at some point.

“Our developed screening programmes for breast, cervical and bowel cancer lead to a higher diagnosis rate also which can skew outcomes, but we are hopefully catching more cancers before they can become a problem.”

Dr Bambury said that in terms of cancer outcomes, “in Ireland in the 90s there was a 40% five year survival rate for all cancer patients, in the noughties that increased to 50-55%, now it’s up to 65%”.

“But as always, there’s things to improve,” he said.

“There’s room for improvement from our perspective in the uptake of screening for bowel cancer, it’s lower than it should be.

“People don’t like the idea of testing stool for blood or having a colonoscopy, so the screening levels are low.

“That’s something the public would do well to be aware of, because the screening detects bowel cancer but also pre-cancerous legions.

“The screening age has decreased to 59, but in the USA, they recommend to start screening at 45 so there’s definitely room to expand the programme further in that regard.”

Improving Ireland’s access to novel drugs is also important, as new medications, once approved by the European Medicines Agency (EMA), “can take two, three or four years to become available because of the lengthy reimbursement process that has to go on between the HSE and the companies that make the drugs”.

“There’s some patients that can go abroad or pay themselves out of pocket, or their health insurance could cover them, but some people can’t get them which does lead to inequalities,” Dr Bambury explained.

“For example, I treat patients with bladder cancer, and there’s a new treatment regimen that can bring many more years of survival, but it’s not yet available in Ireland for public patients.”

Another thing Dr Bambury said is badly in need of improvement is infrastructure.

“Cancer remains the number one cause of death in our population.

“In order to improve cancer care in Cork for the growing and ageing population we need to invest in appropriate infrastructure to include endoscopy and scanning facilities, pathology laboratories, operating theatres, day facilities for the manufacture and administration of chemotherapy and cellular therapies.

“We also need modern cancer care wards,” he said.

“For example, in Cork University Hospital the wards for patients needing to stay in hospital overnight were built in the 1970s so we are working with hospital management on a plan for urgent replacement.

“Once off ‘windfall’ funds going to the public exchequer from sources such as corporation tax would be well spent on once-off modern infrastructure projects like these to provide long term benefit for our population.”