Background:
In 2006, the Republic of Ireland (population 4.6 million) published “A Strategy for Cancer Control in Ireland” and developed a National Cancer Control Programme and National Cancer Screening Services in 2007. Previously, Ireland had poor outcomes and delays in diagnosis. Surgical services were scattered across 36 hospitals.
Aim:
To implement national services providing timely access to evidence based multidisciplinary care.
Methods:
National screening programmes BreastCheck (age 50-64, 72% uptake in 2012) and CervicalCheck (age 25-60, 75% uptake 2012) were implemented in 2007 and BowelScreen in 2012.
Surgical services consolidated in 8 newly designated cancer centres. All 8 centres have high volume, sustainable diagnostics, surgical, medical and radiation oncology. All patients reviewed at multidisciplinary team meetings.
Results:
Breast: 8 hospitals (14,590 urgent referrals seen within 2 weeks and 31,704 non-urgent referrals seen in 12 weeks in 2013. 5.5% had cancer)
Rectal: 10 hospitals
Lung: 8 hospitals, rapid access clinics saw 2,890 referrals in 2013 (30% diagnosed with cancer) (Surgery in 4)
Prostate: 8 hospitals, rapid access clinics saw 2,870 referrals in 2013 (36% diagnosed with cancer)
Pancreatic: 2 centres
Upper gastrointestinal: 4 centres
Brain: 2 centres
Gynaecology: 7 centres
Breast, lung, prostate and melanoma clinical pathways and electronic GP referrals implemented nationally.
Quality assurance programmes in histopathology, imaging and endoscopy implemented.
National Programme for Radiation Oncology: 2 new Dublin centres opened in 2011, 2 in Cork and Galway opening in 2017.
National Medical Oncology Drug Programme and Protocols implemented in 2012,
National treatment guidelines for breast, prostate, lung, GI and gynae cancers in advanced development.
Conclusions:
Radical change has been accomplished nationally in the public sector.
We aim to improve five year survival by up to 10% in most cancers.
Data on patient volumes and performance indicators to be presented at the meeting.