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Report finds improvement in cancer survival rates since centralisation of services

The centralisation of cancer treatment services has resulted in the improvement in cancer survival rates.

A report published by the National Cancer Registry investigates the impact of the centralisation of cancer services in 2007, which resulted in the relocation of treatments to eight designated cancer centres.

The report states that the patients treated in the designated centres have significantly higher survival rates than those in other public hospitals, with survival rates twice as high when it comes to lung, oesophageal and pancreatic cancers.

The strategy resulted in a programme of centralisation of publicly-funded cancer services to eight specialist centres: St James's; the Mater; St Vincent's and Beaumont University Hospital - all in Dublin - and the university hospitals in Cork, Galway, Limerick and Waterford.

The report states that patients in these designated centres are more likely to "receive surgical treatment, radiotherapy, chemotherapy and multi-modality treatment".

"Treatment in designated centres is, overall, associated with higher survival outcomes than for patients in non-designated public hospitals, even after accounting for differences in age, cancer stage and deprivation status of patients seen in different hospitals," the report states.

It is also noted in the report that while centralisation has benefited patients, it is not the only factor contributing to increased survival rates, with improved treatment and screening also important factors.

The analysis presented in the report covers 201,000 individual cancers diagnosed in 196,000 individual patients from 1994 to 2015, with survival rates significantly improving when it came to a number of cancers.

Survival rates in patients with oesophageal cancers improved from 22% in the six years pre-centralisation to 36% in the six years of centralisation. For those with stomach cancer, it has increased from 26% to 36%. In terms of pancreatic cancers, a 7% survival rate at centres before centralisation improved to 19%.

Commenting on the report’s findings, Professor Kerri Clough-Gorr, director of the National Cancer Registry and Professor of Cancer Epidemiology at University College Cork, said, "The findings summarised in this report are reassuring, and confirm that the NCCP’s cancer centralisation programme is working. At the same time, we must acknowledge that centralisation has occurred against a background of other ongoing improvements in Irish cancer services, including increases in the use of appropriate cancer treatments across all hospital types and the introduction of population-based screening programmes, now covering breast, cervical and bowel cancers."

Averil Power, chief executive of the Irish Cancer Society, said the centralisation process means that more patients are being cared for by specialists.

"Being treated by clinical teams with more experience and expertise in their particular cancer significantly increases a patient’s chances of survival," she said.

“The centralisation process, started in 2007, is clearly saving lives. However, it is far from complete. There are still many people with rarer tumours and blood cancers that don’t have a designated centre for their treatment needs. Some patients referred to rapid access clinics are also facing unacceptable delays in accessing life-saving services. These issues must be addressed urgently."