UK survival for major cancers improves, but still lags behind other countries

In collaboration with Adfero

Despite gaining ground, survival figures for newly diagnosed breast, ovarian, bowel and lung cancers were still lower in the UK than in Australia, Canada and Sweden between 1995 and 2007, a new study in the Lancet medical journal shows.

The research looked at one, five-year and five-year 'conditional' survival for these four major cancers between 1995 and 2007 in Australia, Canada, Sweden, the UK (excluding Scotland), Denmark and Norway.

Among other things, one-year survival figures can give information about how late cancers are being diagnosed, as the later cancer is diagnosed the lower the proportion of patients who survive one year.

Five-year 'conditional' survival looks at five-year survival rates among people who survive at least one year, and is thought to be an indication of the quality of care and treatment received.

Survival figures over this period were found to be better for patients in Australia, Canada or Sweden than for those in the UK or Denmark, while Norway's survival rates were intermediate.

For example, five-year bowel cancer survival for 2005-07 was 54 per cent in the UK compared to 66 per cent in Australia, while one-year survival for lung cancer was around 30 per cent in the UK, compared to 43 per cent in Australia and 44 per cent in Sweden.

Experts say that late diagnosis or differences in treatment are likely to be behind the lower survival rates in Denmark and the UK.

But the study also shows that, while the UK's survival rates are not as high as those in other countries, relative survival did improve for all four cancers between 1995 and 2007.

One-year and five-year breast cancer survival rates improved more in the UK and Denmark than in the other countries between 1995 and 2007, indicating that the UK's cancer plans, which were introduced in England in 2000, Northern Ireland in 1996 and Wales in 2004, may have made a difference.

The study authors wrote: "Differences in individual, health-system and clinical factors - such as public awareness of cancer, diagnostic delay, stage [of cancer at diagnosis], comorbidity [other serious illnesses at time of cancer diagnosis] and access to optimum treatment - are all potential explanations for the overall differences in relative survival.

"The patterns are consistent with late diagnosis or differences in treatment, particularly in Denmark and the UK, and in patients aged 65 years and older."

The research was carried out as part of the International Cancer Benchmarking Partnership, a collaboration aimed at understanding the reasons for differences in cancer outcomes between countries. The new paper is the first to emerge from 'module one' of the partnership's work, which aims to generate quality data to base future analyses on.

Other modules will attempt to unpick the reasons for these discrepancies.

Sara Hiom, director of health information at Cancer Research UK, which helped to fund the study, said: "It's encouraging to see that survival for breast, bowel, lung and ovarian cancers has improved across the board and this study shows how far survival has improved for some of the most common cancers in the UK. But we still have work to do. Now we know how we currently compare to other countries, we must look at exactly why these differences in survival exist.

"When the government refreshes its cancer strategy, it's vital to retain a focus on early diagnosis and on improving equitable access to treatment. We also urge the government to continue to collect good quality information. Reliable data - which are consistent across the country - are crucial to understanding the extent of the problem and identifying the causes of the survival gap within the UK and compared to other countries."

Sir Mike Richards, England's national director for cancer, said: "These data will be crucial in helping all the partners involved improve their cancer outcomes.

"In England we have already started work on improving early diagnosis, including a new campaign starting next month to alert people to the early signs and symptoms of bowel, lung and breast cancer, and plans to give GPs more direct access to key diagnostic tests. Full details of our future plans will follow when the coalition government launches its new cancer strategy in the new year."

References

Coleman, M. et al (2010). Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data The Lancet DOI: 10.1016/S0140-6736(10)62231-3