CO124 Gaps in Cancer Screening Uptake in Ireland: Trends, Barriers and Policy Implications

Abstract

Objectives: Cancer remains a leading cause of morbidity and mortality globally, responsible for one in six deaths. In Ireland, cancer incidence has steadily increased, with the country reporting the third-highest age-standardised incidence rate in Europe (344.7 per 100,000 population in 2023). Despite the proven effectiveness of cancer screening in reducing disease burden, uptake of national screening programmes for the prioritised cancers remains suboptimal. This review aimed to assess trends in cancer screening uptake in Ireland relative to national targets and identify key gaps and barriers influencing participation. Methods: A targeted literature review was conducted, to search for peer-reviewed qualitative and quantitative studies published since 2007 from Medline, Scopus, and Elsevier databases. Grey literature, including reports from the National Cancer Registry of Ireland and institutional repositories, was also reviewed. Descriptive analysis was used to summarise screening uptake trends, while thematic analysis was applied to identify gaps and barriers to screening, with emphasis on health system and policy implications. Results: Twelve studies met the inclusion criteria, including one scoping review and five studies conducted during the current National Screening Service (NSS) Implementation Plan (2017-2026). Screening uptake for colorectal and cervical cancer remains below target, at 41.9% (target: 50%) and 78.7% (target: 80%), respectively, based on 2019 data. Breast cancer screening rates were comparatively higher but still face ongoing challenges. Barriers to screening uptake included low public awareness, negative perceptions of screening, inadequate policy frameworks, regional and socio-economic disparities, and limited health literacy. The COVID-19 pandemic contributed to further disruptions in service delivery. Gaps in recent, reliable data were also identified. Conclusions: Several gaps exist in implementation of cancer screening in Ireland. There is a need to understand screening barriers among under-screened populations and to design of innovative, evidence-based communication and policy strategies to improve screening participation and reduce health inequalities.