ICBP findings

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ICBP research is trying to unpick the reasons for existing international cancer survival variation.
 
Our findings seek to better understand the different factors that contribute to this variation, and to compare our partner jurisdictions so that they can learn from each other. In this way, we can provide evidence that can help to create policy and practice change, leading to improved survival for patients internationally.
 
Our findings have shown similarities as well as differences within our partner jurisdictions:
  • Cancer survival improved between 1995 – 2007, but differences still exist
  • Survival during this time period was higher in Australia, Canada and Sweden, intermediate in Norway and lower in Denmark and the UK (England, Northern Ireland and Wales)
  • The general public identified different reasons across jurisdictions for why they might not go to a doctor
  • Primary care doctors across jurisdictions might not refer patients with symptoms in the same way – and this could impact survival outcomes

An analysis of 2.4 million cancer patient records showed that relative survival improved in all jurisdictions between 1995 and 2007. Survival was higher in Australia, Canada, and Sweden, intermediate in Norway and lower in Denmark and the UK (England, Northern Ireland and Wales).

5 year conditional survival for ICBP cancer types from 1995-2007[1]

ICBP 5-year relative survival graphs

The survival ‘gap’ between the best performing countries and the lowest remained largely unchanged – except for breast cancer, where the UK was narrowing the gap. 

A new way to compare different countries’ cancer data was first used for this study. It showed significant differences in stage distribution and stage-specific survival between age groups. Missing stage information was highlighted as a particular issue for older age groups. The analysis highlighted the importance of having consistent and high quality data on stage at diagnosis to enable further insights to be generated.

Cancer survival benchmark using population-based registry data (2011) 

References

[1] Coleman MP, Forman D, Bryant H, et al. 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. Lancet 2011; 377(9760):127-138.

This topic investigated the general public’s awareness and attitudes towards cancer to see if this could explain the differences in cancer survival rates between the jurisdictions. People with low awareness of cancer symptoms or negative beliefs about cancer outcomes may delay going to the doctor when they have symptoms.

The study found similar levels of awareness of cancer symptoms and generally positive beliefs about cancer across all jurisdictions. There was low awareness across all jurisdictions that age is a risk factor for cancer. Respondents in the UK more often reported barriers to seeing their primary care physician (PCP).

ICBP awareness graph

These findings support the continued need for public awareness campaigns around patients, specifically older patients who are more at risk of having cancer, going to their doctors with potential cancer symptoms.

Awareness, attitudes and beliefs about cancer across ICBP jurisdictions (2013)

Find out more on the Cancer Research UK Science Blog

References

[1] Forbes LJL, Simon AE, Warburton F, et al. Differences in cancer awareness and beliefs between Australia, Canada, Denmark, Norway, Sweden and the UK (the International Cancer Benchmarking Partnership): do they contribute to differences in cancer survival? BJC 2013;108:292-399.

This study explored differences in how primary care physicians (PCPs) manage patients with symptoms. A survey was sent to PCPs with direct questions about the environment they work in. It also looked at how PCPs reacted to different types of patients and their symptoms.

PCPs in England, Northern Ireland, and Wales (having the lowest cancer survival rates of the ICBP jurisdictions) consistently reported a lower readiness to refer or investigate patients with potential cancer symptoms. The results also suggested that differences in how PCPs access diagnostic tests and interact with different services within the local health economy may be having an impact on how they then manage these patients.

A health systems ‘mapping’ exercise confirmed some subtle differences between ICBP jurisdictions that need further research. Examples include the nature of a patient’s contribution to health care costs and the ease with which patients can move freely between primary care providers. Both of these may impact on patient or doctor behaviour and so could contribute to differences in cancer outcomes.

Likelihood to refer at first presentation may be linked to survival outcomes (2015)

How might healthcare systems influence the speed of cancer diagnosis? (2014)

Find out more on the Cancer Research UK Science Blog

 

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