SVHG 2016 Cancer Report

5th December 2017

• Nearly half of new breast cancer detections in women at St. Vincent’s University Hospital in 2016 were over 65; women in this age cohort are urged to remain breast aware if not covered by BreastCheck programme.
• More younger people under 50 diagnosed with colorectal and prostate cancers.
• Earlier and more rapid lung cancer diagnoses means improved outlook for patients.
• Skin cancer most common cancer in Ireland, and increasing across all age groups.
• 1,000^th liver transplant carried out by the National Liver Transplant Service at SVUH.

Here are the main findings in the St. Vincent’s Healthcare Group (SVHG) 2016 Cancer Report:

Breast cancer

The number of new patients seen in 2016 increased by 7% to 6,828.

The age profile of patients detected in the Symptomatic Breast Clinic in St. Vincent’s University Hospital (SVUH) shows that most cancers detected were women aged below 50 or above 65 years. Less than 2% were under 35; 25% were under 50, 26% were 50 – 65 and 47% were older than 65.  The total number of new patients diagnosed in the Symptomatic Breast Clinic was 390 and a total of 673 new patients were diagnosed in the Breast Service including BreastCheck.

This shows that nearly half (47%) of new breast cancer cases in women at SVHG in 2016 were over 65 years of age, which highlights the necessity for women over that age to remain breast aware and report any new symptoms.[1] “We expect the age extension of the breast screening programme (now including women up to age 69 years) to improve the outcomes of these women also” says, Dr. Janice Walshe, Consultant Medical Oncologist at SVUH.

Colorectal Cancer

The Colorectal Surgical Unit within SVHG is the largest such unit in Ireland, and in 2016, 400 new patients with colorectal cancer were diagnosed.

“The global increase in rectal cancer amongst younger people has focussed the attention of the cancer community on familial colorectal cancer syndromes. At SVHG we are dedicated to the identification of familial cancer amongst our patients to aid their treatment, and to identify at risk family members. As part of this commitment, we have commenced a dedicated Familial Cancer Clinic with rapid access to germline testing for appropriate patients”, said Mr. Rory Kennelly, Colorectal Surgeon.

 Urology (prostate)

Together with the Mater Hospital, this service provides care to 1.2 million people in the Ireland East Hospital Group (IEHG), and takes referrals from counties; Wexford, Carlow, Kilkenny, Wicklow and South Dublin.

“I think the increased awareness about prostate cancer means that more men are presenting to their GP to get checked. This is one of the reasons why we are seeing more men presenting earlier in their disease and, as a result, they are doing better in treatment. The establishment of the NCCP Rapid Access Prostate Clinic has been fundamental to this”, according to Dr. David Galvin, Consultant Urologist.

HPB (hepato-pancreatic-biliary) cancers

The National Liver Transplant Service is based in St. Vincent’s University Hospital. As a result of this national designation, a large portion of the country’s patients who developed liver cancer – hepatocellular carcinoma (HCC) – are reviewed here.

The number of new HCC diagnoses made in SVUH in 2016 was 105, with referrals from hospitals throughout Ireland. HCC is predominantly a male diagnosis (89% in 2016); the median age for patients is 66, and 15 patients received liver transplants for HCC in 2016.

“Liver cirrhosis is rising exponentially in Ireland. The National Cancer Registry (NCRI) have reported a 300% increase in primary liver cancer over the last two decades. Vincent’s is uniquely placed to treat all patients with hepatocellular carcinoma and this is reflected in the high volume of increased activity in the report”, said Dr. Diarmaid Houlihan, Consultant Gastroenterologist and Hepatologist.

The National Surgical Centre for Pancreatic Cancer (NSCPC) was established at SVUH in 2010, and the number of referrals continues to grow; there was a total of 589 referrals in 2016. Better recognition of pre-malignant conditions of the pancreas and referral for assessment has been a major factor in this regard.

The HPB (hepato-pancreatic-biliary) group in SVUH performs surgery and abdominal organ transplantation, and 2016 was an outstanding year for a number of reasons:

• the unit performed its 1,000^th liver transplant
• the National Pancreas Transplant Programme, which had moved from Beaumont Hospital, was activated in December 2016 and 4 pancreas transplants have been performed to date
• the Neuroendocrine Tumour (NET) Programme achieved European Centre of Excellence accreditation from the European Neuroendocrine Tumour Society (ENETS). It achieved the status of National Centre of Excellence in 2014/2015.

Skin cancer

Non-melanoma skin cancer is the most common cancer in Ireland. The incidence of malignant melanoma, both invasive and in-situ, is increasing across all age groups.

A total of 142 cases of melanoma were diagnosed in 2016.

Lung cancer

Lung cancer is the fourth most common cancer in Ireland. In 2016, the majority of patients (64%) were in their sixties and seventies. There were a total of 214 patients with primary lung cancer diagnosed in 2016; 112 cancers metastatic to the thorax from non-lung cancer primary tumours, and 4 cases presenting with lung cancer recurrence.

“We have seen a rise in the numbers of lung cancer diagnoses at St. Vincent’s each year, largely thanks to the NCCP Rapid Access Lung Clinic and greater awareness of the disease. The outlook for our patients is improving thanks to earlier and rapid diagnosis and a greater breadth of treatment options than in the past, even for more advanced cancers”, said  Dr. Marcus Butler, Consultant in Respiratory Medicine.

Haematology

The Clinical Haematology Department at SVUH provides care for patients with general and malignant haematological disorders, including; leukaemia, myeloma and lymphoma. The age distribution for haematological disorders shows that 74% of all patients are aged 50 years and upwards at the time of diagnosis.

[1] BreastCheck is being extended and by the end of 2021, all eligible women aged 50 to 69 will be invited for routine screening on a phased basis.

2016 SVHG Cancer Report