By Fiona Murphy, Chief Executive, National Screening Service
Our work in the National Screening Service is centred on delivering four national population-based screening programmes, for bowel, breast, and cervical cancer, and for recognising sight-threatening retinopathy in people with diabetes. These programmes aim to reduce illness and suffering from disease (morbidity) and the cancer screening programmes aim to reduce death from cancer (mortality) in the population through prevention and/or early recognition of disease and treatment.
The 17 Global Goals, also known as the Sustainable Development Goals (SDGs), are a call to action to end poverty and inequality, protect the planet, and ensure that all people enjoy health, justice and prosperity. SDG 3 aims to ensure healthy lives and promote wellbeing for all, at all ages, and Target 3.4 aims to “reduce premature mortality from non-communicable diseases through prevention and treatment”. Screening programmes are an example of how we can work towards achieving this goal.
Population-based screening programmes are a key part of Ireland’s strategy for improving the health and wellbeing of our nation. As part of our recently published strategy (Choose Screening), we have renewed our vision and mission to reaffirm our purpose and to clarify our ambition for the future. Aligned with SDG 3, our mission is to deliver population screening programmes that help prevent, reduce the risk of, and assist the recognition of, disease in Ireland; and our vision is to work together to save lives and improve people’s health through population screening.
Global Cancer Trends
The annual World Health Statistics report, published by the World Health Organization (WHO), monitors health for the SDGs. The 2023 report shows a 16% decline in deaths from cancer globally from 2000-2019. The report states that “the availability of early detection programmes strengthens the ability to detect cancers at an early stage, increasing the potential for survival”.
Cancer Trends in Ireland
In September 2022, the National Cancer Registry Ireland published a report on national trends for cancers with population-based screening, namely breast, bowel, and cervical cancer. All three cancers showed favourable trends in incidence, stage, survival and/or death consistent with improvements in early detection and outcomes, with clear evidence for additional or more recent benefits of screening. Screen-detected cancer cases were, on average, detected at a substantially earlier stage than other cases diagnosed at the same ages. Survival has improved for all three cancers, with the biggest improvements seen in the age-groups targeted by the national screening programmes. Death rates of all three cancers have fallen significantly. Decreases in death rates in the age-groups targeted for screening have been more substantial than the overall decreases for all three cancers. From a public health perspective, population cancer screening programmes are delivering on their stated outcomes and are contributing towards achieving SDG 3 - reducing death rates from non-communicable diseases through prevention and treatment.
Cervical Cancer Elimination
We have more to do and our goal, alongside our partners, to eliminate cervical cancer as a public health problem, i.e. to make it a rare disease, is one of the most exciting yet. Ireland is one of the first countries in the world to publicly announce its commitment to the WHO Cervical Cancer Elimination initiative. In January 2023 Ireland published a roadmap to progress the WHO global targets to eliminate cervical cancer and we will announce our target date for elimination in November this year.
Leaving no one behind
The SDGs also call for a world where no one is left behind and it’s a priority in our strategy to reduce inequities in screening. We’re developing a strategic framework to improve equity in our four screening programmes. We want everyone to understand what screening is and to be able to participate in screening if they want to. Screening is a choice and we are committed to ensuring people can actively make that choice by reducing and removing barriers to screening.
Knowing that the contribution we make leads to a reduction in cancer or sight loss and longer healthier lives for so many people in Ireland is a powerful reason to keep going.