This document summarizes Ireland's national strategy for cancer control from 2015-2025. It outlines challenges such as low cancer survival rates compared to other European countries. Solutions proposed include centralizing specialist cancer services, expanding medical oncology nationwide, and developing a molecular diagnostics strategy. Key goals are to reduce cancer incidence and mortality through prevention, screening, and state-of-the-art treatment. The national cancer control program will focus on quality data, research, and addressing gaps in clinical staffing over the next ten years.

1. Dr Jerome Coffey MD FRCPI FRCR FFRRCSI
Interim Director, NCCP
National Healthcare Conference
Dublin, May 28th 2015
Cancer 2020

2.  Challenges
 Solutions
 Strategy
 Action

3. The Challenge
Dr Susan O’Reilly MB, FRCPC, FRCPI
Photo courtesy of David Branigan, Oceansport

4. Cancer Projections for Ireland 2015–2040
2015 2020 2025 2030 2035 2040
% increase
2010 -2040
Females 14322 16172 18202 20295 22368 24287 84%
Males 17008 19692 22658 25775 28855 31704 107%
Total 31330 35864 40860 46070 51223 55991 97%
www.ncri.ie

7. Email: nicr@qub.ac.uk Tel: +44 (0)28 9063 2573 Website: www.qub.ac.uk/nicr
0
5
10
15
20
25
30
1 2 3 4 5
Deprivation QuintileEASRper100,000 least
deprived
most
deprived
Lung Cervix Stomach
Deprivation & Cancer

8. Global surveillance of cancer survival 1995–2009: analysis of individual data
for 25 676 887 patients from 279 population-based registries in 67 countries
(CONCORD-2)
Claudia Allemani, PhD, Hannah K Weir, PhD, Helena Carreira, MPH, Rhea Harewood, MSc, Devon Spika, MSc, Xiao-Si
Wang, PhD, Finian Bannon, PhD, Jane V Ahn, MSc, Christopher J Johnson, MPH, Audrey Bonaventure, MD, Rafael Marcos-
Gragera, PhD, Charles Stiller, MSc, Gulnar Azevedo e Silva, ProfMD, Wan-Qing Chen, PhD, Olufemi J Ogunbiyi,
ProfFWACP, Bernard Rachet, FFPH, Matthew J Soeberg, PhD, Hui You, MAppStats, Tomohiro Matsuda, PhD, Magdalena
Bielska-Lasota, ProfMD, Hans Storm, MD, Thomas C Tucker, ProfPhD, Michel P Coleman, ProfFFPH
The Lancet
Volume 385, Issue 9972, Pages 977-1010 (March 2015)
DOI: 10.1016/S0140-6736(14)62038-9
Copyright © 2015 Allemani et al.

9. Revealed: Irish cancer survival rates lowest in Europe
03:55, 19 April 2015 by Susan Mitchell
Cancer survival rates in Ireland are amongst the lowest in Europe, new
figures show. The figures were laid bare in a major global report that
represents the most comprehensive international comparison of cancer
survival to date. Cancer survival rates for common cancers – including
breast cancer, cervical cancer, ovarian cancer and rectal cancer – were
the lowest of all comparable 16 countries examined by this newspaper.
http://www.businesspost.ie

10. The unsolvable mystery of our low cancer survival rates
03:55, 19 April 2015 by Susan Mitchell
Millions have been invested in cancer care in Ireland, but we continue to
lag behind the rest of Europe on survival rates. Despite the efforts made
by successive governments, the National Cancer Control Programme
and the HSE to raise cancer survival rates, Ireland has failed to catch up
with other European countries…
http://www.businesspost.ie

11. Irish government deficit compared to
other European countries and the US
wikipedia.org/wiki/European_debt_crisis

12. http://www.tradingeconomics.com/ireland/government-debt-to-gdp

13. Cancer Drug Expenditure
€0
€50,000,000
€100,000,000
€150,000,000
€200,000,000
€250,000,000
2009 2010 2011 2012 2013 2014*
Hospital
Community

16. Solutions

17. Cell 161, 1215-1228, May 21, 2015

18. Slide 18Copyright © Evinance Innovation Inc. 2015
Our platform reduces costs & improves quality by enabling
evidence-based decision making
May 2015
contact: chad.armstrong@evinance.com

19. Slide 19Copyright © Evinance Innovation Inc. 2015
Evinance
Workflow Adherence
Decision Support
Clinical
Trials
Guidelines
Patient Data
EHR CIS

20. Slide 20Copyright © Evinance Innovation Inc. 2015
Clinical Consult Note

21. Slide 21Copyright © Evinance Innovation Inc. 2015
Prompts

22. Slide 22Copyright © Evinance Innovation Inc. 2015
Recommendations

23. Slide 23Copyright © Evinance Innovation Inc. 2015
Real-Time Dashboards

24. Slide 24Copyright © Evinance Innovation Inc. 2015
Patient Paths
Pt. X

25. Strategy

26. • Cancer surgery delivered in 32 hospitals
• Low volumes, poor outcomes, cancer scandals: delayed Dx / Tx
• Lack of focus on Primary Care and patient pathways
• No co-ordinated national plan for screening, surgery, radiation,
medical oncology
• Eight Autonomous Health Boards
Small health boards did not have the population to support specialist cancer
services
Some health boards had 3 or more competing hospitals of equal size and
status
• Delays in service developments
Prior to 2006
slide courtesy Dr. Marie Laffoy

27. Ireland will have:
• A system of cancer control which will reduce
cancer incidence, morbidity and mortality rates
relative to other EU 15 countries by 2015
• A network of equitably accessible state-of-the-art
cancer treatment facilities.
• We will become an internationally recognised
location for education and research into all
aspects of cancer.
• Irish people will know and practice health-
promoting and cancer preventing behaviours and
will have increased awareness of and access to
early cancer detection and screening.
2nd National Cancer Strategy
slide courtesy Dr. Marie Laffoy

29. 2015

32. “National Cancer Strategy 2006:
A Strategy for Cancer Control in
Ireland”
Evaluation Panel Report
Warde et al

35. The NCCP will continue to implement the strategy for cancer control
and to plan, support and monitor the delivery of cancer services
nationally.
Top 5 in 2015
1. Audit, Quality & Risk Forums: Breast, Lung, Prostate & Pancreas
2. National Medical Oncology Clinical Information System
3. Launch of Breast and Prostate cancer evidence-based clinical
practice guidelines
4. Partnership with National Cancer Screening Service
5. Pilot single KPI for wait times for elective cancer surgeries

36. Developments 2015
Priority posts:
1. National Lead Hereditary Cancer Service, NCCP & SJH
2. Medical Oncologists x 2
3. Specialist Oncology Nurses (CNS/ANP level) x 2
4. Urologist x 1 (S/SW Hospital Group)
5. Second Paediatric Radiation Oncologist, SLRON & OLCHC

37. Funded Service Developments 2015 (2)
Capital:
1. Additional linear accelerators x 2, St. Luke’s Hospital
2. Initial planning and design work, St. Luke’s Centre at Beaumont
3. Cross-border project in Altnagelvin
Community Oncology:
1. Support and deliver cancer education and training programmes.
2. Pilot and Implement a Survivorship Patient Treatment Summary
and Long-term Care Plan

38. Medium & Longer Term
 Data Culture: Quality & Outcomes
 Centralisation of Surgical Oncology*
 Expansion of Medical Oncology
 Radiation Oncology in Altnagelvin, Cork, Galway & Dublin
 National Oncology Drug Management System (estd. 2011)
 Oncology Medication Safety Review (estd. 2014)
 NCCP Alignment with Clinical Strategy & Programmes Division
 NCCP Alignment with Hospital Groups, CHOs
 Molecular Diagnostics Strategy

39. The Next Ten Years
 Plan for growth in incidence, prevalence & complexity
 Resolve the gaps in clinical and allied health staffing
 Invest in molecular diagnostic and personalised medicine
 Emphasise research, innovation and productivity
 Foster prevention and screening
 Focus on survivorship