Northern Ireland

The State of Cancer Services

In Northern Ireland, there are approximately 9,829 new cancers diagnosed and approximately 3,814 deaths from cancer each year—making cancer the second most common cause of death after diseases of the circulatory system. Survival rates for common cancers currently stand at 80.3% for breast cancer; 8.5% and 9.3% for lung cancer in males and females respectively; 50.4% and 53.7% for colorectal cancer in males and females respectively; and 71% for prostate cancer.

Cancer care is provided to the 1.7 million people living in Northern Ireland through five Health and Social Care (HSC) Trusts. Specialist radiotherapy services are currently provided by the Northern Ireland Clinical Cancer Centre (NICC) at the Belfast HSC Trust, which opened in March 2006.

In addition to the specialist cancer care provided in the NICC and at the four cancer units in the other Trusts, community support and care are also provided across Northern Ireland. Additional investments for cancer services and developments are planned, including adding consultant medical staff, improving access to radiotherapy, and introducing cervical and prostate brachytherapy.

An Overview of Cancer Services

Cancer Screening Programmes

Cancer screening programmes in Northern Ireland include the following:

• Breast cancer screening was extended from women aged 50-64 to women aged 50-70 in 2009, enabling an additional 45,000 women to be invited for breast screening across Northern Ireland. The area's breast cancer screening uptake rate has been increasing steadily on a yearly basis and is currently at 76%. There is a 97% survival rate at five years for those women who have been detected to have breast cancer through the screening programme.
• Cervical cancer screening is offered to women between the ages of 20-65. The cervical cancer screening uptake rate has been increasing steadily on a yearly basis and is currently at 75%, with approximately 120,000 women aged 20-64 years being screened for cervical cancer.
• Colorectal cancer screening is now offered to men and women between the ages of 60 and 69 as of April 2010.

Cancer Service Framework

The Department of Health, Social Services and Public Safety (DHSSPS) has introduced a programme aimed at facilitating the development of a range of service frameworks that will establish evidence-based, quantifiable standards for health and social care. In 2005, DHSSPS established the Northern Ireland Cancer Network (NICaN) to promote equal access to high-quality, patient-focused and clinically-effective cancer care. NICaN supports professionals, patients, and volunteers in working together to achieve these goals.

NICaN is leading the charge on developing a cancer service framework for cancer prevention, treatment, and care. This framework will entrench standards for the prevention, treatment, care, rehabilitation, and palliative care services provided to individuals and communities at greater risk of developing cancer. The cancer service framework will also set standards for improving the patient experience, promoting the quality of health, and providing palliative/end-of-life care services, as well as specific standards for:

• Breast cancer
• Central nervous system cancer
• Child and youth cancer
• Colorectal cancer
• Skin cancer
• Endocrine cancer
• Gynaecological cancer
• Haematological cancer
• Head and neck cancer
• Lung cancer
• Sarcoma
• Upper gastrointestinal cancer
• Urological cancer

NICE Guidance

The National Institute for Health and Clinical Excellence (NICE) disseminates evidence-based guidance on a range of issues. In 2008, NICE guidance was endorsed as applicable in Northern Ireland on a number of cancer therapy standards, including the following:

• Rituximab for the treatment of relapsed or refractory Stage III or Stage IV follicular non-Hodgkin's lymphoma.
• Pemetrexed for the treatment of non-small cell lung cancer.
• Pemetrexed disodium for the treatment of malignant pleural mesothelioma.
• Bortezomib monotherapy for the treatment of multiple myeloma.
• Carmustine implants and temolozomide for the treatment of glioma.