independent

Friday 22 November 2019

New 'cancer atlas' shows risk regions

WEXFORD IS HIGHER RISK FOR SEVERAL TYPES

ELAINE FURLONG

A NEWLY unveiled cancer map, which reveals the pattern of the disease by geographical area, has found that Wexford is among the areas of highest risk of cervical cancer, of higher relative risk for both lung cancer and melanoma, and of a high relative risk for bladder cancer in men.

These conclusions are to be found in a major new survey by the National Cancer Registry and its Northern Ireland equivalent.

Wexford is featured in the findings of nine cancers that were surveyed for the 'All-ireland Cancer Atlas 1995-2007'.

The study found that the areas of highest risk of cervical cancer were concentrated around Dublin, along the east coast to Wexford, and westwards into the midlands.

In terms of colorectal cancer, although the geographical variation in relative risk was fairly modest, there were distinct areas of higher relative risk for colorectal cancer for both men and women. The pattern for both sexes combined showed a higher relative risk around Cork city and county, with a diffuse pattern in the north extending in a band from Donegal across to Dublin and to a lesser extent in south Waterford and Wexford. The pattern for men showed some smaller areas of higher risk Wexford as well as the counties of Waterford, Mayo and Derry.

Wexford was among the area of higher relative risk for lung cancer. The study found that the geographical pattern of the relative risk of lung cancer was similar for men and women. For both sexes combined, areas of higher relative risk were seen in Leinster, including Wexford, while the pattern for women showed higher relative risk also in Leinster, concentrated in Wexford, among other counties.

Areas of higher relative risk for melanoma of the skin were seen in 'a clear band' running along from south Wexford through Waterford to west Cork for both men and women. Melanoma of the skin had a strong geographical pattern, which was similar for men and women

The geographical pattern of bladder cancer for both sexes was mainly determined by the pattern for men, due to their higher incidence rate. For men, there were several areas of high relative risk, including the east coast from Louth to Wexford.

The geographical pattern of relative risk for kidney cancer showed only modest variation, which was different for men and women. For both sexes combined, the area of highest relative risk was mainly confined to Leinster. For men, the relative risk was higher in a wide band across the country extending from Sligo to Wexford.

Oesophageal cancer had a strong geographical pattern, which was similar for men and women. For both sexes combined there was a large area of higher relative risk extending south of a line from west Cork to Dublin with smaller areas of higher risk in Belfast, Carrickfergus, Larne and Ards. Areas in the west and north-west had a lower relative risk. The area of higher relative risk for men was slightly smaller and more diffuse, extending north-eastwards from Cork to the north-east of Antrim (including Belfast) and including most of the east of Ireland, with the exception of the area around Wexford.

Among their findings for prostate cancer, researchers stated that it was 'of interest' the noticeable fall in relative risk between 19952001 and 2002-2007 in the former South Eastern Health Board area, which includes Wexford. The researchers explained that although the GP referral guidelines from the National Cancer Control Programme state that PSA testing of asymptomatic men or PSA screening is not national policy, this seems to have had only a limited impact on practice in the Republic of Ireland, where PSA testing was at a very high level during the period covered by the atlas. ' The changes in geographical patterns of risk within ROI are likely to reflect changes in testing and biopsy rates, due to a combination of awareness and implementation of policy by GPS, demands by patients and investigation rates by specialists,' stated the researchers, who later added that it would be interesting to investigate which, if any of the factors listed above were responsible for this change.

One of the final cancers to be surveyed concerning Wexford was Leukaemia, where there was a secondary area of higher risk extending from south Dublin to Wexford. The survey found that for both men and women the geographical pattern was of a smooth gradient in risk; lowest in the northeast and highest in the south-west. For men in particular the area of highest risk seemed to centre on Limerick and Clare rather than the extreme south-west and for both sexes there was a secondary area of higher risk, extending from south Dublin to Wexford.

The report found that the risk of many cancers is related to how much social or economic deprivation there is in an area. Lung, stomach, head and neck and cervical cancer risk was found to be higher in areas of high unemployment or where fewer go on to higher education; however, skin, breast and prostate cancer risk was lower in these areas. The risk of non-melanoma skin cancer is higher in more affluent areas. Generally, the risk of cancer is higher in more densely populated areas and where there are larger numbers of elderly living.

National Cancer Registry director Dr Harry Comber explained that most of the geographical variations are due to lifestyle and personal characteristics and have 'nothing to do' with treatment services.

He also commented that areas with unexplained higher than average risk should but studied in detail.

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