ICBP findings and impact
Summaries of our findings, impacts and next steps of the ICBP.
The ICBP has pioneered a range of methods and research tools to enable robust international comparisons, resulting in 13 high quality peer reviewed papers published to date, with more in the pipeline. An international survival benchmark is underpinned by additional research modules which each explore different aspects of the cancer pathway.
The ICBP publishes showcase reports highlighting findings, impacts and ongoing research. We also produce information brief to report additional insights or to highlight key information.
The ICBP aims to provide evidence across jurisdictions and cancer types for improvements that could lead to increased survival. Many ICBP findings and insights have already informed policy developments. Some of the impacts of the ICBP include:
- Providing evidence that underpins cancer plans in Victoria, Scotland, England and Norway.
- Contributing to the development of lung cancer initiatives in Alberta and Wales.
- Catalysing efforts to improve cancer data completeness and availability in NSW, Ontario, England and Wales.
- Initiating the Accelerate, Evaluate, Coordinate (ACE) programme exploring innovative diagnostic referral pathways in England.
- Providing evidence for initiatives in Scotland and Wales to improve access to diagnostics.
- Facilitating engagement exercises with PCPs in Manitoba about barriers to accessing diagnostics, including urban/rural issues.
Analysis of 2.4 million cancer patient records showed that relative survival improved in all jurisdictions over this period. Survival is 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
The survival ‘gap’ between the best performing countries and the lowest remains largely unchanged – except for breast cancer, where the UK is narrowing the gap. The patterns were consistent with later stage at diagnosis or differences in treatment, particularly in Denmark and the UK, and in older patients (those aged 65 or over).
A new algorithm was created so that different staging systems could be compared. It demonstrated 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 emphasised the importance of having consistent and high quality data on stage at diagnosis to enable further insights to be generated.
 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.
The aim of this research topic was to investigate 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 suspicious 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).
Awareness of age as a risk factor across ICBP jurisdictions
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.
The Awareness and Beliefs about Cancer (ABC) questionnaire is an internationally validated tool which was used to survey 19,079 respondents. The tool was tested in all participating countries with minor variations included to allow for differences in cultural and health systems.
The ABC tool is available for use by interested researchers. For more information please contact the ICBP team.
 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 (PCP) manage symptomatic patients in participating jurisdictions. A survey was sent to PCPs with direct questions about the local health economy and hypothetical patient scenarios to identify what actions respondents would take.
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 compared to PCPs in other jurisdictions. The results also suggested that differences in how PCPs access diagnostics and interact with different services within the local health economy may be having an impact on that actions taken by clinicians.
A health systems ‘mapping’ exercise confirmed that there are many common features of health care systems between partner jurisdictions, with some subtle differences needing further research. Examples include understanding differences in 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 examples may impact on patient or doctor behaviour and so could contribute to differences in cancer outcomes.
Showcasing our findings and impacts
Showcase reports provide an update on progress within the partnership, including findings the impacts of our research and ongoing studies. These reports provide an overview of the partnership at certain points in time.
ICBP posters and presentations
Our findings are being reported at conferences around the world. Some of our latest posters and presentations can be found here:
ICBP work often feeds in to other reports, a selection of which are found below: