Dr. Jerome Coffey:

To take Deputy Durkan's points in reverse order, his last point is very interesting, because we are currently at the point in cancer care where we are looking at the genetic make-up of a patient with a tumour to determine whether he or she will respond to treatment. If he or she will not respond, we can choose not to give him or her the treatment, which would only cause side effects. If we were in a position five or ten years down the road, or sooner, to determine from a blood test a person's genetic make-up, the likelihood that he or she will benefit from a vaccination and the likelihood that he or she will develop side effects, it would completely change and enhance the way in which we make those decisions. That point is well made.

The first point was about data and geographical variation. The National Cancer Registry is excellent at putting up on its website heat maps or distribution maps illustrating where there are higher incidences in one location compared with the national rate. It is interesting to look at these maps. If one looks at the slides it put up this week, which illustrates the newest data from the period up to 2014, one sees higher incidences in metropolitan or city areas for most of the common cancers. When one looks at a report it put out a year or two ago, under the direction of Dr. Harry Comber, about inequality in incidence, it considered at a number of factors. It looked at differences between young and old. There is a higher incidence in the older age group. It looked at socio-economic factors, which is probably an area in which we could have an impact if we focused education and intervention in the lower socio-economic areas where there are higher rates of lifestyle-related cancers such as head, neck and lung cancer. The report also looked at rural and urban living as factors. There is a higher incidence of some cancers in rural areas. People will not move to the country just to mitigate that risk but I take the Deputy's point on the importance of data and interpreting it to guide where to focus investment and where developments need to take place.