CANCER
Major increase in cancer cases expected
Lifestyle factors and increasing age reflected in latest projections by National Cancer Registry Ireland
January 31, 2014
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The incidence of cancer in Ireland is expected to double by 2040.
According to the latest projections by the National Cancer Registry Ireland (NCRI), between 2010 and 2040, the number of cancers is expected to increase for all cancer types, except leukaemia in men.
Based on changes in population size and age distribution, the total number of new invasive cancer cases is projected to increase by 107% for males and 84% for females. However, if trends in incidence since 1994 are also taken into account, cases could increase by up to 133% for men and 125% for women.
According to NCRI director, Dr Harry Comber, the main reason for this is increasing age.
"By 2040, the CSO (Central Statistics Office) projects that the population of people over the age of 70 will have increased by 125% and one is closely related to the other," he explained to Irishhealthpro.com.
However, there are of course other factors too. Currently, 40% of total cancer risk in the UK has been attributed to five lifestyle factors - smoking, overweight/obesity, diet, lack of exercise and alcohol use. Dr Comber noted that Ireland would have a similar risk profile.
In the case of smoking for example, this is expected to have a major impact on the incidence of lung cancer over the next 25 years.
According to the NCRI projections, the incidence of lung cancer is expected to increase more rapidly in females. By 2040, the rate is expected to be 136% higher among women than in 2010. Among men, it is expected to increase by 52% during the same period.
"This is directly down to smoking. Twenty years ago, men were quitting smoking more than women and this is now feeding into the lung cancer figures," Dr Comber explained.
Overall, the most rapidly increasing cancers in both men and women are expected to be skin cancers - both melanoma and non-melanoma.
Malignant melanoma is the most serious type of skin cancer. It develops in cells in the outer layers of the skin and can grow from a mole, freckle or a normal part of the skin. Spotting a melanoma early and getting it treated as soon as possible can save your life. Non-melanoma skin cancer is the most common and easily treated type of cancer.
Dr Comber said that this is largely because ‘what has happened in the past tends to continue', and there has been a big jump in skin cancer cases in recent years. This is down to sunlight exposure. Let's face it, we all know people (or we are those people) who see the sun in Ireland and immediately go out it in with little or no sunscreen on. Dr Comber noted that in 1990s especially, people ‘appeared to be very naïve about the dangers of the sun'.
Meanwhile, the NCRI also projects big increases in cancers of the colon and rectum, which are expected to rise by up to 130% between 2010 and 2040.
Cancers of the upper gastrointestinal tract, including cancer of the oesophagus and pancreas, are also expected to increase by over 100% by 2040.
Meanwhile, the number of patients having cancer-directed surgery is expected to increase by up to 55% between 2010 and 2025, while the number of people having chemotherapy during this period is expected to increase by up to 48% and the number having radiotherapy by up to 35%.
According to the NCRI, ‘these changes, combined with increasing survival, will inevitably increase the burden on the cancer services'.
For example, because of the ageing of the population and improved life expectancy, the average age of cancer patients at diagnosis is set to increase.
"Cancers will be diagnosed in an older population, which will have different needs, and clear guidelines will be needed on the assessment and treatment of older patients," the NCRI said.
It also pointed out that the ‘growing availability and use of ever more sophisticated and expensive targeted therapy' will contribute to lead to better survival rates, ‘but the high costs of these therapies, especially for advanced disease, will need to be balanced against other priorities in cancer care'.
But will the health service be ready to cope with this increasing burden? That, according to Dr Comber, is a question for health planners, such as the National Cancer Control Programme.
"People are aware of these figures. This is coming down the tracks - it is not speculation. Even if you introduced 100% screening capabilities tomorrow, most of this would still happen," he warned.