PATIENTS WITH lung cancer are diagnosed at a much later stage of the disease in the Republic than in other European countries, a leading European cancer expert has said.
Speaking at the fifth All-Ireland Lung Cancer Conference in Dublin on Saturday, Dr Nils Wilking, consultant clinical oncologist at the Karolinska Institute in Stockholm, said Ireland was top of the European table for late-stage lung tumour diagnosis.
Acknowledging that the data available to him might not represent the latest figures, Dr Wilking said Ireland was also the worst in Europe when access to anti-tumour therapy was measured. Some 54 per cent of lung cancer patients received no active treatment here compared with 21 per cent in Sweden and 19 per cent in the Netherlands.
However, the Republic is mid-table when it comes to a country-by-country comparison of the number of patients offered surgical treatment for lung cancer. And it also does well in terms of national spending on cancer in general, at €150 to €200 per capita, coming just below Austria, Norway and France. Dr Wilking said that, based on 18-month-old statistics, the Republic was one of the countries with low access to radiotherapy machines. Along with surgery and chemotherapy, radiotherapy is a key method of treating cancer.
At four machines per million population, Ireland is on par with Russia, Poland and Hungary. Countries with high access, defined as more than six radiotherapy machines per million people are France and the Scandinavian states.
“Countries who are successful in dealing with the burden of lung cancer seem to have anti-smoking policies, access to multi-modality therapy and a public awareness of the disease leading to early diagnosis,” the cancer expert told the meeting.
In an outline of the problems facing cancer patients across Europe, Dr Wilking said unequal access to healthcare was a major factor. As well as increasing the risk of suboptimal treatment, inequality meant that a person’s income may determine access to the best treatment.
Without equal access to effective healthcare there is a danger of undermining support for public health. “The informed and rich will opt out (of the public system) while the informed and poor will be frustrated,” he said.
Asked about geography as a factor in accessing quality cancer treatment, Dr Wilking said that in Sweden the maximum distance that 90 per cent of cancer patients need to travel to obtain radiotherapy is the equivalent of about two hours travelling. And he said that reasonable access to radiotherapy has become a political issue in Sweden.
Referring to the principal cause of lung cancer, Dr Barry O’Connell, consultant in respiratory medicine at St James’s Hospital, Dublin, warned that Ireland is not winning the smoking battle at present. “The next big issue is ensuring access to surgery for lung cancer patients, where appropriate,” he added.
Addressing the experience in Northern Ireland, Dr Dermot Hughes, consultant pathologist at Altnagelvin hospital, Derry, said integrated and co-ordinated care improves outcome for lung cancer patients. But he noted that inequality persists even in a health system that is free at the point of entry, as is the case on Northern Ireland. “Those most likely to have the disease have least access to the service,” he said.