Bernard Durkan (Kildare North, Fine Gael)
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Question 156: To ask the Tánaiste and Minister for Health and Children the extent to which she has evaluated trends in respect of the various forms of cancer on a county basis; if she has considered the cause or causes for higher levels in certain areas and regions; and if she will make a statement on the matter. [9730/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The national cancer registry has statutory responsibility for the collation and analysis of information on incidence and prevalence of cancer in Ireland. Reports of the registry have examined variations in incidence of cancer among counties and former health board areas during the period from 1994 onwards. Variations in case numbers, overall or for particular cancers, obviously reflect variations in population size or in population age-structure. Age-standardised rates show less variation, but nevertheless some variation is evident, although for most counties or Health Service Executive areas, rates do not show statistically significant variation from the national average. The main exception is Dublin and the eastern regional area, where incidence rates are higher than the national average for cancers as a whole, and for a number of individual cancers, including lung, breast and prostate cancers. For lung and a number of other cancers, variation is strongly influenced by smoking, which tends to be most prevalent in urban, particularly deprived urban, areas. For breast and prostate cancer, incidence rates may be increased in areas where there are higher levels of screening, for example, breast screening. In general, cancers not strongly influenced by smoking, socio-economic or screening-related factors show less marked variation within Ireland, and any such variation cannot readily be attributed to specific factors without further research into specific cancers. Distinguishing true geographic variation from random or chance variation is also a problem given the small numbers of cases involved at county level for most cancers.

Statistical and epidemiological protocols have been devised to help evaluate small area clusters where higher than normal incidences of cancer are believed to exist. Responsibility for examining such clusters rests with the Health Service Executive in the area.