Michael Finneran (Roscommon-South Leitrim, Fianna Fail)

I will be taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I welcome the opportunity to address the House on male cancer services and cancer screening for male cancers.

When we speak of male cancer, many people will automatically think of prostate cancer. Figures from the National Cancer Registry show that prostate cancer is the commonest cancer diagnosis in men, accounting for 29% of cases. The stark figures behind the percentages are that on average every year more than 2,400 men are diagnosed with prostate cancer and approximately 540 die of the disease.

The reorganisation of breast cancer services has probably been the most high profile aspect of the work of the national cancer control programme, NCCP, over the past two years. However, considerable work has also been done on services for prostate cancer and the key initiative this year has been to speed up access to diagnosis and multidisciplinary treatment. The NCCP is putting in place rapid access diagnostic clinics for prostate cancer in each of the eight designated cancer centres. This is crucial in improving outcomes. Comparison with other jurisdictions shows that advanced stage of disease at presentation is more common in Ireland and access to diagnosis for prostate cancer has been problematic.

To date, rapid access diagnostic prostate cancer clinics operating under the national guidelines have commenced in University College Hospital Galway and St. James's Hospital. Two further clinics, in Beaumont and St Vincent's, are due to open before the end of this year and the remaining four will open in 2010. In due course, when all eight clinics are in place, they will be run within national guidelines so that from one part of the country to another, the service is the same and the opportunity for best outcomes is the same.

Prevention and early detection are also key features of the national cancer control strategy. There is as yet, however, insufficient evidence to support a population-based screening programme for prostate cancer. The Department of Health and Children and the National Cancer Screening Service are keeping emerging evidence about prostate cancer screening under review, including the results of randomised trials that are being conducted internationally.

While prostate cancer is the most common cancer in men it is not the source of the greatest mortality. Lung cancer is the biggest cause of cancer death in men. In 2006, the latest year for which figures are available, 964 men died from lung cancer. In the same year, 585 men died from colorectal cancer while 543 men died from prostate cancer.

As with prostate cancer, the NCCP has been working this year to develop services for lung cancer and rapid access diagnostic clinics for lung cancer have now opened in St. Vincent's, Beaumont and St James's. A fourth clinic, at University College Hospital Galway, is due to open before the end of this year and the remaining four clinics are on schedule to open as planned in the first half of 2010. As for screening patients for lung cancer, no effective test has been developed and routine screening X-rays have not been shown to improve outcomes.

Colorectal cancer is the second most common cancer in men. Overall, the incidence rate of colorectal cancer in Ireland ranks among the highest in western Europe and survival rates are also lower in Ireland compared with our European counterparts. There is widespread agreement that highly technical rectal cancer surgery must be performed by specialist cancer surgeons to achieve the best possible outcome. The NCCP accepted a recommendation from the Irish Society of Coloproctology that the number of hospitals performing rectal cancer surgery should be reduced to 13 public hospitals from January 2010 with a goal of reducing this number to the eight designated cancer centres as surgical capacity is created.

Unlike lung and prostate cancer screening, screening for colorectal cancer would be highly effective. The national cancer screening service has submitted proposals for a national colorectal screening programme to the Minister. The Minister is anxious, notwithstanding the current budgetary situation, to introduce such a programme as soon as possible and is examining options in this regard.

Considerable progress has been made this year to improve cancer services for men with the goal of achieving better outcomes. I have also outlined the position on screening and while the evidence does not support population-based screening for prostate cancer or lung cancer, there is a very strong case for the introduction of colorectal cancer screening and this will be a priority for the Minister as resources become available.