Last reviewed: 17 October 2025
Last reviewed: 17 October 2025
Phase 2 of the ICBP examined international differences in cancer survival, incidence, mortality, as well as access to diagnostics and treatment, health system structures, and cancer care pathways. The updated international cancer survival benchmark was published in *Lancet Oncology*, followed by over 40 peer-reviewed publications. These included site-specific analyses for ovarian, lung, colorectal, oesophageal, liver, pancreatic, and stomach cancers, and explored stage distribution and survival by stage, incidence trends by subtype, and age disparities for some sites. Findings from exploratory modules provided insights into the factors contributing to survival differences across jurisdictions.
The SurvMark-2 project analysed data from 3.9 million cancer cases across 21 jurisdictions in 7 countries between 1995 and 2014. It calculated age-standardised 1- and 5-year survival, mapping these against incidence and mortality trends. Survival improved across all cancer sites, with narrowing international differences in 1-year survival and 5-year survival (except pancreas). Younger patients (<75 years) experienced greater gains. Australia, Canada, Denmark and Norway consistently showed higher survival estimates, while the UK had lower survival for most cancers, with some exceptions (ovarian 5 year, oesophageal 1 year)
1-year net survival changes(PDF, 1.3 MB)
5-year net survival changes(PDF, 1.2 MB)
Key Publication:
SurvMark-2 had 17 published papers in total including 7 stage papers, all of which can be accessed through the link below:
SurvMark-2 Publications (PDF, 125 KB)
Research explored how differences in access to diagnostic services contributed to international survival disparities. Studies examined PET-CT service provision and variation in primary care referral pathways. These findings highlighted the importance of timely and equitable access to diagnostic tools in improving cancer outcomes.
Key Publications:
PET-CT service provision across ICBP countries
Variation in primary care referral pathways
Researchers at CRUK investigated variation in treatment guidelines and their implementation. The ovarian cancer treatment study revealed significant international differences in treatment approaches and outcomes. A subsequent study developed an international consensus on actions to improve lung cancer survival, including improved screening initiatives, quicker diagnosis, improved treatment centres, international audits and improved policies.
Key Publications:
Variation in Ovarian Cancer Treatment by Stage
Variation in Lung Cancer Treatment by Stage
Professor Ellen Nolte led this module examined how various health system factors influenced cancer outcomes. The team developed a conceptual logic model and published studies on health service capacity, the role of leadership, and the evolution of cancer policies. These findings helped explain subtle survival differences across jurisdictions.
Key Publication:
Professor Yoryos Lyratzopoulos led research into cancer care pathways, examines international differences in cancer treatment pathways across eight cancer types. It highlights variation in the proportion of patients diagnosed via emergency presentation across jurisdictions and analyses variation in chemotherapy and radiotherapy treatment use, showing how age, stage and sex influence access to care and outcomes. The findings support efforts to improve equity and timeliness in cancer treatment across high-income countries.
Key Publications:
Radiotherapy use and time-to-treatment
Chemotherapy use and time-to-treatment
Variation in lung cancer treatments by stage
Variation in ovarian cancer treatment by stage
Changes in colorectal cancer incidence
New approaches to cancer care in a COVID-19 world
Measuring up: how does the UK compare internationally on cancer survival?
Are differences in treatment driving variation in ovarian cancer survival internationally?
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