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Cancer remains one of the most pressing public health challenges across the European Union (EU). Research commissioned by the European Commission for the European Parliament and the EU Council reveals staggering statistics: in 2020, 2.7 million individuals within the EU were diagnosed with cancer, and 1.3 million succumbed to the disease.
These figures underscore a worrying trend. While Europe comprises only a tenth of the world’s population, it bears the burden of a quarter of the world’s cancer cases. Projections suggest that, without decisive action, the number of cancer-related deaths in the EU will increase by over 24% by 2035, positioning cancer as the leading cause of mortality within the bloc.
Such projections demand urgent, coordinated efforts at both the national and EU levels. The fight against cancer necessitates innovative public health strategies, increased funding for research, and collaborative initiatives that leverage best practices across member states. In this context, Ireland’s experience and strategies provide valuable insights into how focused policies can mitigate the impact of this disease.
Ireland’s National Cancer Strategy
In Ireland, the National Cancer Strategy 2017–2026 outlines the country’s comprehensive approach to cancer prevention, treatment, and care. When launched, the strategy anticipated a near doubling of cancer cases by 2040, driven largely by Ireland’s growing and aging population. The strategy identified concerning patterns of increasing cancer incidence tied to socio-economic deprivation. Specifically, cervical, lung, and stomach cancers were found to have age-standardised rates 120%, 60%, and 40% higher, respectively, among the most deprived populations.
The economic implications of such trends are profound. A surge in cancer diagnoses not only places immense pressure on healthcare infrastructure but also incurs significant costs in treatment, care, and lost productivity. Consequently, Ireland’s strategy underscores the importance of early detection, targeted public health interventions, and equitable access to care as pillars of its cancer control efforts.
Despite the ominous projections, the National Cancer Registry has provided a glimmer of hope, noting that recent trends in age-standardised cancer incidence rates—measuring an individual’s risk of being diagnosed with cancer—show a levelling-off or even a decline for some cancer types. If sustained, these trends could result in fewer cancer cases than originally predicted. This optimism reflects the potential of proactive, evidence-based interventions to counteract broader demographic and epidemiological trends.
Cervical Cancer in Ireland: Challenges and Progress
One of the key areas of focus in Ireland’s fight against cancer is cervical cancer. Ireland’s Health Service Executive (HSE) recently unveiled the Cervical Cancer Elimination Action Plan 2025–2030, which aims to make cervical cancer a rare disease in all Irish communities. This aligns with Ireland’s commitment to the World Health Organization’s (WHO) global initiative to eliminate cervical cancer, with a target date of 2040.
The plan adopts the WHO’s definition of elimination as achieving fewer than four cases per 100,000 women annually. Encouragingly, Ireland’s rate of cervical cancer has been on a steady decline, dropping from 15.8 cases per 100,000 in 2008 to 10.1 in 2022. However, the disease still affects around 300 women annually, with 90 deaths reported within this group. These statistics reflect both the progress made and the work yet to be done to eliminate this preventable cancer.
Key Initiatives in Cervical Cancer Elimination
To achieve the ambitious goal of eliminating cervical cancer, the Irish government has embraced the WHO’s targets:
- Vaccinating 90% of girls against HPV by age 15,
- Screening 70% of women by age 35 and again by age 45,
- Treating 90% of individuals diagnosed with cervical disease.
Ireland’s Minister for Health has expressed confidence that these targets will not only be met but exceeded, thanks to a robust approach informed by international research. A collaboration with Australia’s Daffodil Centre modelled the impact of HPV vaccination rates, screening coverage, and population data, establishing 2040 as a feasible elimination target.
This model highlights the importance of addressing structural factors that influence cancer prevention and control. Public health education campaigns, investments in screening infrastructure, and community engagement initiatives are integral to achieving high vaccination and screening rates, particularly among underserved populations.
HPV Vaccination in Ireland
A cornerstone of Ireland’s efforts is its comprehensive HPV vaccination programme. Since 2010, girls in their first year of secondary school have been vaccinated through the National Immunisation Programme, with boys added to the programme in 2019. The vaccine, recommended by the National Immunisation Advisory Committee (NIAC), offers protection against a range of HPV-associated cancers, including cervical, vaginal, vulval, oropharyngeal, anal, and rectal cancers.
In late 2022, the Irish government launched the Laura Brennan HPV Vaccination Catch-Up Programme, named after the late HPV vaccination advocate. This initiative provided free HPV vaccines to females aged 24 or younger and males aged 21 or younger, achieving an estimated uptake rate of 78.4% among first-year students in 2022–2023. Approximately 11,000 individuals received vaccinations through the catch-up programme.
Early research from Ireland’s National Screening Service shows promising protective effects of the HPV vaccine in young women attending their first cervical screening. These findings demonstrate the programme’s potential to significantly reduce HPV-associated cancers in the coming decades.
However, sustained efforts will be needed to address vaccination gaps among underserved communities, where factors such as socio-economic status, cultural attitudes, and access to healthcare may limit uptake. Expanding the reach of vaccination programmes and addressing these barriers will be critical to achieving equitable health outcomes.
Restoring Trust in Cervical Screening: The CervicalCheck Controversy
Ireland’s progress in cervical cancer prevention has been shadowed by the CervicalCheck scandal, which erupted in 2018. The controversy revealed that more than 200 women who developed cervical cancer had not been informed about earlier misdiagnosed smear tests. Public trust in cervical cancer screening plummeted, prompting a comprehensive review of the programme.
Investigations, including the Scoping Inquiry into CervicalCheck led by Dr. Gabriel Scally and a review by the Royal College of Obstetricians and Gynaecologists (RCOG), found that while CervicalCheck operated at international standards, there were significant governance issues.
Dr. Scally’s final progress review in 2022 affirmed that the programme has since been strengthened and continues to save lives. He urged women to take full advantage of the screening service, highlighting its critical role in early cancer detection.
The controversy underscores the importance of transparency and accountability in maintaining public trust. Robust mechanisms for oversight and quality assurance are essential to ensuring that screening programmes operate effectively and equitably.
Legislative and Institutional Reforms
In response to the scandal, Ireland enacted the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023, which became effective in September 2024. The legislation mandates transparency and accountability across public and private healthcare services. Its implementation is expected to bolster trust in Ireland’s health system and reinforce a culture of openness in patient care.
This law represents a critical step toward ensuring that patients are informed about adverse incidents in their care, fostering a healthcare system that prioritises safety, transparency, and patient rights. The success of such legislation will depend on its enforcement and the commitment of healthcare providers to its principles.
Balancing Challenges with Optimism
Ireland’s battle against cervical cancer illustrates the complex interplay between systemic challenges, public health initiatives, and individual outcomes. While the CervicalCheck controversy revealed serious institutional shortcomings, it also catalysed reforms that have strengthened Ireland’s approach to cancer prevention and treatment.
The preventative measures now in place, particularly the HPV vaccination programme and the enhanced screening services, are yielding measurable benefits. As Ireland advances toward its goal of eliminating cervical cancer by 2040, the nation serves as a model for how evidence-based policies and public health commitment can address even the most daunting health challenges.
Expanding the Fight: Lessons for Broader Cancer Prevention
Ireland’s success with cervical cancer elimination highlights the importance of prevention, early detection, and public trust in healthcare systems. The National Cancer Strategy’s emphasis on tackling socio-economic disparities points the way forward for addressing other cancer types, such as lung and stomach cancers, which disproportionately affect deprived communities.
Building on existing successes will require further investment in targeted public awareness campaigns, equitable access to screening and treatment, and continued legislative support for transparency and accountability. These efforts can reinforce Ireland’s position as a leader in cancer prevention while saving countless lives.
In addition, addressing lifestyle-related risk factors such as smoking, obesity, and alcohol consumption will be crucial to reducing the incidence of other preventable cancers. Public health policies that promote healthier environments, coupled with community-based interventions, can play a pivotal role in lowering cancer rates across the population.
Conclusion
Cancer remains a significant public health challenge across the EU and Ireland. However, Ireland’s proactive approach—grounded in robust vaccination programmes, enhanced screening, and legislative reforms—offers hope. The steady decline in cervical cancer rates and the alignment with WHO targets demonstrate that ambitious goals, backed by evidence and public trust, can be achieved.
As Ireland continues its journey toward eliminating cervical cancer, its successes and lessons learned can inspire similar efforts across the EU and beyond. These efforts provide a roadmap for addressing other cancers, fostering a healthier future for all. By addressing structural inequalities and prioritising prevention, Ireland exemplifies how a nation can overcome significant health challenges while building a foundation for long-term public health success.