THE FIRST major audit of cancer care by a large hospital in the Republic has shown a strong link between smoking and a variety of cancers.
The audit, conducted by St James's Hospital, Dublin found that 79 per cent of males diagnosed with cancer at the hospital had a history of smoking. In women with cancer, some 57 per cent were either current or past smokers.
The audit, details of which were released yesterday, also found that three-quarters of patients treated for cancer at the Trinity College Dublin teaching hospital were over the age of 50. The report covered six years, from 2001-2006.
Unsurprisingly, 93 per cent of patients treated for lung cancer had a history of smoking. The role of tobacco was significant in other cancers as well: 70 per cent of those with oesophageal and colon cancers had smoked at some point. Among patients with cancers of the head and neck, two-thirds had a history of smoking.
The report also highlighted the role of family history among newly diagnosed patients. Some 54 per cent of breast cancer patients had a family history of a cancer, while 39 per cent had a family history of breast cancer.
Between 30 and 40 per cent of those diagnosed with colorectal, oesophageal and lung cancers had a family history of cancer.
One-third of all cancer day care treatments in the State were administered at St James's Hospital, reflecting the move towards day care treatment of cancer as well as the range of sub-specialist cancer care provided by the hospital.
The audit found that 62 per cent of oesophageal cancers and 47 per cent of blood system malignancies were referred to St James's by other hospitals in the State. And, comparing 2006 with 2001, there has been a 54 per cent increase in the number of new patients referred to the hospital with colorectal cancer and a 109 per cent increase in new cases of urological cancers.
Almost 20 per cent of cancer patients enter into medical trials as part of treatment and the entire cancer programme at the hospital is linked to the on-site Institute of Molecular Medicine, a research facility.
Breast cancer services at the hospital follow the recommendations of the 2000 O'Higgins report for a specialist breast unit. A rapid access, triple assessment breast clinic was established at St James's in 1997. Some eight in 10 women with breast cancer that is managed at the hospital are diagnosed on a same-day basis. All cases of suspected breast cancer are discussed at a multidisciplinary conference involving specialist doctors, nurses and allied health professionals.
According to the report, one-third of breast cancer patients treated at St James's receive a combination of surgery, radiotherapy, hormone therapy and chemotherapy. Eighty eightpercent of patients started treatment within a month of diagnosis, while the five-year survival for breast cancer patients was 74 per cent.
Consultant general surgeon Prof John Reynolds said: "The data compiled in this audit across the cancer spectrum demonstrates that the treatment programme at St James's has achieved stage-for-stage cure rates that benchmark favourably with outcomes from the best international standards."