Cancer Inequalities in Ireland: new report by National Cancer Registry

A major new report, published online by the National Cancer Registry today, highlights strong patterns of cancer inequality by deprivation, age and, to a lesser extent, urban/rural status. These factors influence the risk of developing cancer (incidence) and the survival, stage at presentation, treatment and associated health conditions (comorbidities) of cancer patients in Ireland. In many instances, these patterns of inequality apply across a range of cancer types.

Graph of least vs. most deprived groups

The report focuses on the patients diagnosed with cancer during the years 2008-2012. Findings are presented for cancer as a whole and for nine major cancer types: colorectal, stomach, lung, female breast, cervical and prostate cancers, melanoma of skin, lymphoma and leukaemia. Patients were assigned a deprivation score and urban/rural status on the basis of their Electoral District (ED) of residence. The Pobal 2006 index of deprivation used is based on information collected on education, unemployment and other socioeconomic factors during the 2006 Census. Click here to download a pdf of the report’s key points or here for the full report.

Particularly notable (and statistically significant) findings in this report include:

  • Higher cancer incidence in urban than in rural populations, overall (about 10% higher) and for six out of nine cancer types: stomach, lung, male colorectal, female breast and cervical cancers, and melanoma (13%-38% higher depending on the cancer, highest for lung cancer).
  • Higher cancer incidence in the most deprived compared with the least deprived 20% of the population, overall (by 10% for males and 4% for females) and for three cancer types: stomach cancer (40% higher), lung cancer (60% higher) and cervical cancer (120% higher). However, the opposite pattern (lower incidence in the most deprived populations) was seen for breast cancer (15% lower) and melanoma (30% lower).
  • Poorer survival of patients from the most deprived populations; for all cancers combined, patients from this group were about 40% more likely to die from their cancer (within five years of diagnosis) than those from the least deprived group[, or 27% more likely if cancer type was adjusted for]. Seven of the nine cancer types examined also showed poorer survival in the most deprived group, with patients’ risk of dying from their cancer 20-50% higher depending on the cancer; this applied to stomach, colorectal, lung, breast and prostate cancers, lymphoma and leukaemia.
  • Poorer survival of older patients for all cancer types examined; overall, patients aged 75+ years at diagnosis were about four times more likely to die from their cancer than those aged 45-54 years, or about three times more likely if the type of cancer involved was adjusted for. Differences in survival between older and younger patients were greatest for breast and prostate cancers and lymphoma, and least for stomach, colorectal and lung cancers.
  • Lower use of surgery among patients from the most deprived group, overall (6% lower in relative terms) and for stomach, colorectal, lung, breast and prostate cancer (4%-19% lower depending on the cancer).
  • Lower percentages of the oldest patients (age 75+ years) having any tumour-directed treatment compared with those aged 45-54 years: all treatment types combined (30% lower use in relative terms), surgery (21% lower), radiotherapy (22% lower) and chemotherapy (72% lower). This applied to almost all major cancer types. However, use of hormonal treatment for breast and prostate cancers was higher in older patients.
  • Higher prevalence of comorbidities (other serious health conditions) in the oldest patients (about 2.5 times higher than at ages 45-54) and patients from the most deprived group (about 20% higher than in the least deprived group).

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