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BMJ. 2007 August 25; 335(7616): 363.
PMCID: PMC1952525

Cancer survival in UK is improving but could be better

Survival of UK patients after cancer is improving but still lags behind the European average, despite the United Kingdom spending more than other countries on cancer, different sources of data published this week show.

Figures from the Office for National Statistics (ONS) show that between 1999 and 2004 survival rates for most cancers in England improved.

However, two studies published in Lancet Oncology (doi: 10.1016/S1470-2045(07)70245-0 and doi: 10.1016/S1470-2045(07)70246-2) say that numbers of UK patients surviving at five years after diagnosis, though improving, are still below the European average and roughly the same as in countries that spend less than a third of the UK's per capita healthcare budget.

The government and experts on cancer have defended the UK's performance, saying that the Lancet Oncology studies cover a period that began before specific strategies to improve cancer services in the UK came into being, such as the NHS cancer plan of 2000.

The two studies in Lancet Oncology came from the Eurocare group, an international collaboration whose population based analyses were based on patients with cancer in 83 registries in 23 countries.

In the first study, researchers from Italy reported survival data for 2.7 million adult cancer patients with eight types of cancer: breast, colorectal, lung, melanoma, ovary, prostate, testis, and Hodgkin's disease.

They compared patients whose cancer was diagnosed in 1995-9 with those whose cancer was diagnosed in 1990-4. The authors also analysed five year relative survival for all cancers combined, and they compared findings according to countries' total national expenditure on health.

The authors said that if all countries in their analysis attained the mean survival (57%) of Norway, Sweden, and Finland—some of the best performers—around 150 000 fewer people would die in the five years after diagnosis. The average survival at five years for the whole of Europe is 52%, while in the UK it is 48%.

The ONS statistics show that the situation has been improving in England. It looked at survival statistics among adults in England whose cancer was diagnosed during 1999-2003 and who were followed up to the end of 2004. The data cover the 21 most common cancers.

The figures show that survival from breast cancer at five years was 81% for women who were given a diagnosis during 1999-2003, around one percentage point higher than for women whose cancer was diagnosed during 1998-2001. For prostate cancer the percentage of men surviving rose from 70.8% to 74.4%.

In an accompanying comment in Lancet Oncology, the Department of Health's national cancer director, Mike Richards, said that the UK's poorer results were attributable mainly to patients having more advanced disease at diagnosis, indicating that “particular emphasis should be put on achieving earlier diagnosis.”

A health department spokesperson said: “Cancer services in England have made great improvements since we published the NHS cancer plan in 2000.

“Between 1996 and 2004 cancer mortality in people under 75 fell by nearly 16%. This equates to over 50 000 lives saved. Our cancer survival rates have doubled in the last 30 years. But we know we still have much to do.

“We are currently working with people from across the field of cancer to develop a new cancer reform strategy.”

Richard Sullivan, director of clinical programmes for the charity Cancer Research UK, said, “Comparisons between countries are difficult because survival data are not collected in the same way in all places.

“Cancer is still not being diagnosed early enough in all cases. This study shows that cancer is certainly not a ‘ticked box.' We need a sustained effort to beat the disease.”

Notes

The ONS figures on cancer survival are available at www.statistics.gov.uk.


Articles from The BMJ are provided here courtesy of BMJ Publishing Group