One in 23 persons Living In Ireland Following Invasive Cancer Diagnosis

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Prof Jerome Coffey
Prof Jerome Coffey
Prof. Deirdre Murray
Prof Deirdre Murray

By the end of 2021, the number of people in Ireland living following an invasive cancer diagnosis had almost reached 215,000, according to the 2023 Annual Statistical Report from the National Cancer Registry of Ireland (NCRI).

This was equivalent to 4.3% of the population, or about 1 in 23 persons in Ireland, a 50% increase in the number of cancer survivors compared with one decade ago.

The report said this reflected both an increase in the number of people diagnosed with cancer every year and ongoing improvements in cancer survival. 

Over the years 2019-2021 the average number of ‘registered tumours’ in males and females was estimated at 41,767 per year. Just over 1 in 2 (24,424 excluding non-invasive tumours and non-melanoma skin cancers) were life-changing invasive cancers which often required extensive treatment.

Of all deaths occurring in 2021 in Ireland, 28% (more than 1 in 4) were attributable to cancer.  On average during 2019-2021 there were 9,621 deaths per year from invasive cancer (5,184 in males, 4,436 in females), or 9,874 deaths per year across all tumour types.

The report, titled Cancer in Ireland 1994 – 2021, is an analysis of nationally collated data revealing the status of cancer in Ireland and focuses on the impact of age and stage at diagnosis on cancer outcomes.

Key findings included:

  • Early diagnosis was associated with better cancer outcomes, reduced complexity of care for patients and lower cost of cancer care. A high proportion of some cancers, e.g. melanoma, uterine and prostate cancers, presented  at early stage with consequent 5-year net survival of up to 100% in many cases. The report reiterated the importance of early diagnosis with 5-year net survival above 90% for stage I and II breast and colorectal cancers and 95% and 80% for stage I and II cervical cancer, respectively.  Cancers with a population screening programme also experienced high 5-year net survival when detected in early stages. However,  stage IV presentation remained common for some other cancers, e.g. head and neck, pancreatic and lung cancers, with consequent poorer outcomes.
  • Older people experienced higher cancer incidence and lower survival rates compared to other age groups. Five-year net survival for those aged 75 and older was 46%, compared with 86% for those in the 15 – 44 year age group. Internationally, it has been shown that many factors underlie these findings including delayed diagnosis as older people may present later for medical attention of symptoms, patients having other serious illnesses which limit treatment options, poorer treatment tolerance, reduced physiological reserve and lack of representation in clinical trials.
  • The number of invasive cancers (excluding non-melanoma skin cancers) presenting as an emergency was estimated at 14% during 2016-2019, down almost 6% since 2002. This fall from 20% to 14% was observed between 2002 and 2009, after which no further reduction was evident. The cancers with the highest rate of emergency presentation were cancers of the brain, pancreas, liver, gallbladder/biliary tract, lung, ovary, and colon.  Unfortunately, emergency presentation was associated with more advanced stage and therefore limited treatment options and poorer survival outcomes.
  • More complete data on the impact of the COVID-19 pandemic on cancer diagnoses in 2021 indicated that the pandemic resulted in a 4% reduction in cancer diagnoses compared to what was expected that year. Early indicators suggested a return to expected rates of cancer diagnoses in 2022.
  • Excluding non-melanoma skin cancer (NMSC), prostate and female breast cancer were the most commonly diagnosed invasive cancers overall, and each comprised almost one-third of all invasive cancers in men and women respectively during the period 2019-2021.  Colorectal cancer, lung cancer, melanoma of skin and non-Hodgkin lymphoma were the 2nd, 3rd, 4th and 5th most common cancers in males, respectively.  Lung cancer, colorectal cancer, melanoma of skin, and uterine cancer were the 2nd  3rd, 4th and 5th most common cancers in females respectively.
  • Lung cancer was the leading cause of cancer death in both sexes during 2019-2021. In males, cancer of the prostate, colorectal, pancreas and oesophagus were the 2nd, 3rd , 4th and 5th most common categories of cancer deaths, respectively. In females, cancer of the breast, colorectal, ovary and pancreas were the 2nd, 3rd and 4th most common categories of cancer deaths, respectively.
  • The top six most common cancers among survivors were: breast cancer (23% of all cancer survivors), prostate cancer (22%), colorectal (bowel) cancer (11%) and skin melanoma (7%), non-Hodgkin lymphoma (4%) and lung cancer (4%) which together account for 71% of all cancer survivors. These figures excluded non-melanoma skin cancers, which are rarely fatal.
  • For all invasive cancers (excluding non-melanoma skin cancers), five-year net survival averaged 65% for patients diagnosed during 2014-2018, compared with only 44% for those diagnosed during 1994-1998, an improvement of 21 percentage points. Major improvements in survival were also been seen for most forms of cancer between 1994-1998 and 2014-2018. For the most common cancers, prostate cancer survival improved by 28 percentage points, colorectal cancer by 17 percentage points, breast cancer by 16 percentage points, and lung cancer by 15 percentage points.