Cancer: new research shows Northern Ireland lagging behind when it comes to key treatment

Shock new research has today (Tuesday) laid bare how far Northern Ireland is lagging behind other countries when it comes to treating cancer.

According to two international studies, patients received less key cancer treatment such as chemotherapy and radiotherapy than Australia, Canada, Norway and much of the rest of the UKP.

The Cancer Research co-funded studies found patients in Northern Ireland over a five-year period received less chemotherapy (28.8%) than people in Norway (39.1%), Canada (38.5%) and Australia (42.1%).

Those in Northern Ireland also experienced long waiting times to start treatments, waiting on average 57 days to start chemotherapy compared with 48 days in England and 39 days in Norway, according to the new studies published today in The Lancet Oncology. 

Cancer Research branded the findings from the International Cancer Benchmarking Partnership "worrying" and said it might help explain why cancer survival in Northern Ireland lags behind other countries internationally.  

The ICBP is an international partnership of clinicians, academics, policy makers and data experts, hosted by Cancer Research UK and chaired by Professor Mark Lawler, Professor of Digital Health at Queen’s University Belfast, which carries out research to help identify best practice internationally. 

It is the first time that treatment differences for eight different cancers (oesophageal, stomach, colon, rectal, liver, pancreatic, lung and ovarian cancer) have been examined across countries in three continents.  

The researchers from University College London, Queen’s University Belfast and other centres examined data from more than 780,000 people with cancer diagnosed between 2012 and 2017 - the most up-to-date analysis of international treatment differences - in four comparable countries (Australia, Canada, Norway and the UK).* 

Among those four countries, there was stark variation in the treatment of all eight cancer types. People with cancer in the UK received less chemotherapy and less radiotherapy than comparable nations.  

For example, fewer lung cancer patients in Northern Ireland (22.9%) received chemotherapy compared with Canada (35.0%), Norway (45.3%) and Australia (41.4%). 

Fewer older patients in Northern Ireland were treated with chemotherapy and radiotherapy - for example, only 13.4% of those aged 75-84 received chemotherapy in Northern Ireland, compared with 29.6% in Australia and 23% in Norway.  

People in Northern Ireland experienced longer waiting times to start treatments than other European countries, with an average wait of 53 days for radiotherapy compared with 44 in Norway, but less than the rest of the UK where there were average waits of 63 days in England, 79 days in Scotland and 81 days in Wales.

The average wait to start chemotherapy in Northern Ireland was 57 days compared with 39 in Norway, 43 in Australia, 48 in England, 58 in Wales and 65 in Scotland. 

Chemotherapy and radiotherapy are key treatment options for patients diagnosed with cancer - it is estimated around 4 in 10 people with cancer in the UK should receive radiotherapy as part of their care.**

Cancer Research UK’s public affairs manager for Northern Ireland, Barbara Roulston, said the statistics were concerning and she called on the Stormont Executive to act as quickly as possible.  

“Northern Ireland should be striving for world-leading cancer care," she said.

"All cancer patients deserve to receive the highest quality of care, but this research shows that people in Northern Ireland received less chemotherapy and radiotherapy than comparable countries.

“The findings also expose Northern Ireland’s long waiting times for treatment. Behind these statistics are people waiting anxiously to begin treatment that is key to boosting their chances of survival.”

In a statement the Department of Health in Northern Ireland told Downtown Radio & Cool FM that demand on Northern Ireland’s health service has outstripped capacity for many years resulting in the "unacceptable" waiting times currently faced by patients here.

"The figures released today show that neighbouring jurisdictions are also facing similar pressures with patients having to wait too long to commence treatment," the statement added.

"Transformational change is required to improve cancer care. The Cancer Strategy for Northern Ireland 2022-2032 sets the direction of travel for cancer services for the next 10 years, with the vision to ensure everyone has equitable and timely access to the most effective, evidence-based referral, diagnosis, treatment, support and person-centred cancer care.

"Whilst the Department working with stakeholders is progressing the ambitious delivery plan set out in the Cancer Strategy as far as possible, full implementation can only be achieved with significant, sustained investment over a number of years. In the absence of an agreed multi-year budget for health, the ability to strategically plan has been and remains extremely challenging."

ICBP Chair and Professor of Digital Health, Queen’s University Belfast, Professor Mark Lawler, added: "Taken together with other ICBP research, this landmark study, based on data from nearly 800,000 patients, suggests that those countries with more frequent use of chemotherapy and radiotherapy achieve better outcomes.

"Given the current underinvestment in radiotherapy in the UK, our data emphasises that we must ensure the optimal use of radiotherapy to deliver modern cancer care.

“Taken together with other ICBP research, this landmark study, based on data from nearly 800,000 patients, suggests that those countries with more frequent use of chemotherapy and radiotherapy achieve better outcomes. Given the current underinvestment in radiotherapy in the UK, our data emphasises that we must ensure the optimal use of radiotherapy to deliver modern cancer care.

“As I presented recently in evidence to the Health and Social Care Select Committee Inquiry on the Future of Cancer, countries with robust cancer strategies have seen larger improvements in survival than the UK*** and this current research can help us to understand the impact of treatment differences on cancer outcomes.

“From a Northern Ireland perspective, our involvement in ICBP is critical. We can learn a great deal from other countries who have stepped up and substantially improved cancer services. It’s crucial the Northern Ireland Executive addresses these issues and invests in its new cancer strategy and the excellent cancer professionals that work tirelessly to ensure the best possible outcomes for patients in Northern Ireland.” 

According to the charity, with cancer cases projected to rise in Northern Ireland, demand for treatments like chemotherapy and radiotherapy will substantially increase. And a wider range of people, including older people with more complex healthcare needs, will require cancer treatment.