Dr. Jerome Coffey:

I thank the Chairman and committee members for the invitation to appear before them. I am honoured to have been nominated to chair the National Cancer Registry Board. In this brief opening statement, I would like to focus on the development of cancer services in Ireland over the last decade, the central role of the National Cancer Registry Board in this and the likely direction of short and medium-term developments.

By way of introduction I am a radiation oncologist, appointed to the St. Luke's radiation oncology network in 2006. I succeeded my colleague and mentor, the late Professor Donal Hollywood, as radiation oncology adviser to the national cancer control programme in March of 2010 and, at the end of 2014, I took on the role of director of the national cancer control programme within the HSE.

In May 2015, the steering group and patient forum charged with developing the third national cancer strategy were established and they concluded their work two months ago. It became clear through my work as a member of the steering group how much has changed in cancer services since publication of the last strategy in 2006. The programmatic approach and the national scale of organisation and investment have been commended by an international external evaluation panel and are in perfect alignment with EU cancer control principles.

The concentration of specialist staff in the designated cancer centres has enabled multidisciplinary decision-making and the co-ordination of patient-centred care. At the same time, there has been integration between primary care and hospital care with collaboration between the national cancer control programme and the Irish College of General Practitioners on developing referral guidelines and electronic referral systems for common cancer types.

In preparation for today’s meeting, I have reviewed the National Cancer Registry Board (Establishment) Order of 1991, under the Health Act 1961, and the 1996 and 2009 amendments to the order. I have read the annual reports and accounts from 2007 onwards and I have made contact with the outgoing board chair and all current board members.

The statutory functions of the NCRB are to collect and analyse information relating to the incidence and prevalence of cancer and to promote and facilitate the use of the data thus collected in approved research projects and in the planning and management of services. By international standards, the registry has been hugely successful in fulfilling these functions. For example, completeness of population coverage is 100%. Registry data are used as the starting point for all local and national cancer service design projects.

Based on the work of the registry, we know that the incidence of cancer will go up by 50% between 2015 and 2025 and by approximately 100% by 2040. These figures underline the importance of the third national cancer strategy, to be published by the Minister shortly. From this, several things have to happen as a matter of urgency. Approximately 40% of cancers can be attributed to lifestyle factors so we have to focus heavily on cancer prevention, good examples being the Healthy Ireland initiative and HPV vaccination. Second, we have to stress the importance of early diagnosis, screening, direct access to diagnostics for GPs and a net increase in the capacity of the health care system to absorb the very significant projected increase in patient numbers.

The increase in the number of both patients and long-term survivors will generate a very large volume of additional data for the registry to collect, analyse and share. To meet this challenge, there is a clear opportunity to automate and facilitate data collection from hospitals by linkage to the national medical laboratory information system, MedLIS, the national medical oncology clinical information system, MOCIS, and other clinical datasets. The registry makes its anonymised data freely available to inform clinicians, health care providers and external researchers. It has its own highly productive research output and this is going to expand significantly since the appointment of the current director, Professor Kerri Clough-Gorr, last year. This is an innovative joint appointment creating a new post of professor of cancer epidemiology at University College Cork.

I reiterate the importance of the national cancer registry as a critical element of cancer services in this country. The NCRB will become an increasingly important agency as we anticipate a return on Exchequer investment in prevention, diagnostics and treatment reflected by way of improved cancer survival rates and other outcomes. I would be honoured to contribute to its future.