Cancer rates and dis­ad­van­taged ar­eas

The Irish Times - - Comment & Letters -

Sir, – Your edi­to­rial of De­cem­ber 4th about cancer be­com­ing the com­mon­est cause of death men­tions health in­equal­i­ties in pass­ing.

You fail to ob­serve that death rates for some of the com­mon­est can­cers are twice as high in ar­eas of most dis­ad­van­tage com­pared with the most af­flu­ent.

The causes of this may be mul­ti­fac­to­rial, but what is cer­tain is that ac­cess to the health ser­vice in such ar­eas in a sig­nif­i­cant con­trib­u­tor to the lack of preven­tion and early de­tec­tion of cancer.

Much higher num­bers of peo­ple in ar­eas of dis­ad­van­tage get mul­ti­ple ill­nesses (in­clud­ing cancer) at a younger age, of­ten com­pli­cated by psy­choso­cial problems. Yet re­sources are dis­trib­uted ac­cord­ing to pop­u­la­tion num­bers and not need, re­sult­ing in huge short­falls in ser­vices where they are needed most.

While gen­eral prac­tice is in cri­sis all over the coun­try, nowhere is this more ev­i­dent than in dis­ad­van­taged ar­eas where it is al­most im­pos­si­ble to re­cruit, be­cause of the par­tic­u­lar chal­lenges com­bined with lack of ad­e­quate sup­port both in prac­tice and the wider pri­mary care team.

GPs are ideally trained and placed for preven­tion and early de­tec­tion of cancer which are so crit­i­cal to re­duc­ing death rates. How­ever in these ar­eas, where there are not nearly enough GPs or sup­port staff, they are com­pletely over­whelmed with the larger num­ber of younger, sicker pa­tients with acute health and so­cial problems, which are so de­mand­ing that there is no time to ad­dress is­sues of preven­tion or early de­tec­tion. Up­take of cer­vi­cal smears is much lower in our ar­eas – if we are un­der pres­sure to treat an acute prob­lem like a chest in­fec­tion, while ad­dress­ing se­ri­ous mental health problems, a chronic ill­ness like di­a­betes, and deal with an acute cri­sis like im­mi­nent home­less­ness, it’s not pos­si­ble to per­suade ei­ther doc­tor or pa­tient that her smear takes pri­or­ity.

With a packed wait­ing room out­side, nei­ther is there time to con­sider that she might need a chest X-ray for her cough, or spend time dis­cussing smok­ing.

This gap for GPs be­tween what they are do­ing and what they could be do­ing is hard to tol­er­ate.

It is ex­tra­or­di­nary that a mech­a­nism such as the Deis schools sys­tem in the Depart­ment of Ed­u­ca­tion has never been used in the health ser­vice to di­rect re­sources where they are needed most. Mean­while, your like­li­hood of dy­ing younger will con­tinue to be de­ter­mined by where you live. – Yours, etc,

Dr EDEL McGINNITY, Mul­hud­dart,

Dublin 15.

Newspapers in English

Newspapers from Ireland

© PressReader. All rights reserved.