ICBP Research Publications

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If you have any views or comments about the  partnership, we would like to hear from you.

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The ICBP funds and produces high impact, peer reviewed publications. All published papers relating to the partnership are listed on this page, alongside a summary of the paper and a link to the original journal article.

We have to date published papers showing international cancer survival variation, differences in awareness and beliefs about cancer and the role of primary care in cancer diagnosis.

The ICBP encourages other researchers to maximise data collected by the ICBP to further unpick factors that may be causing this observed survival variation. If you would like to know more about what data is available, please contact the ICBP Programme Management team (icbp@cancer.org.uk).

You can also download a comprehensive list of the papers published using ICBP data:

ICBP publications

This paper provides a good summary of the reasons why the ICBP was established in 2009, the structure of the partnership and early findings. International research collaborations can be complex, and a consideration of the benefits and difficulties of these kinds of partnerships is also discussed.

Read more about the Partnership in the Health Policy journal

The ICBP: An international collaboration to inform policy (2013)


Data from population-based cancer registries was used to estimate 1-year and 5-year cancer survival for breast, colorectal, lung and ovarian cancer patients diagnosed between 1995 and 2007. Relative survival improved in all studied ICBP jurisdictions during this time, but survival outcomes varied.

Benchmarking cancer survival 1995-2007 (2011)

Differences in how a cancer’s stage is recorded means it can be difficult to compare internationally. Stage information for studied cancer types was mapped into ‘localised, regional and distant’ categories to allow for data to be compared.

Comparability of ICBP stage data (2012)

By comparing the stage distribution of patients diagnosed with ovarian cancer between 2004 and 2007, the role of stage at diagnosis in international cancer survival differences can be explored.

Ovarian cancer survival and stage at diagnosis (2012)

By comparing the stage distribution of patients diagnosed with breast cancer between 2000 and 2007, the role of stage at diagnosis in international cancer survival differences can be explored.

Breast cancer survival and stage at diagnosis (2013)

By comparing the stage distribution of patients diagnosed with colon or rectal cancer between 2000 and 2007, the role of stage at diagnosis in international cancer survival differences can be explored.

Colorectal cancer survival and stage at diagnosis (2013)

By comparing the stage distribution of patients diagnosed with lung cancer between 2004 and 2007, the role of stage at diagnosis in international cancer survival differences can be explored.

Lung cancer survival and stage at diagnosis (2013)


Following from previous ICBP research into ovarian cancer survival in Manitoba, local researchers explored the features of these types of cancer over a 20 year period, and assessed the most recent data available.

Ovarian cancer in Manitoba between 1992-2011 (2017)


In similar health systems, differences in cancer survival may be down to the attitudes and awareness of the general population. This research shows that across participating jurisdictions, awareness and beliefs are similar, but people report different reasons for not going to their doctor with worrying symptoms.
International variation in awareness and beliefs about cancer (2014)

To see if international variation in cancer survival could be explained by different beliefs and awareness about cancer in the general population, a telephone survey was carried out in people over 50 years of age.

The Awareness and Beliefs about Cancer tool (2013)


Many cancer patients report not going to a doctor because they did not realise a symptom was 'suspicious'. The authors examined how long members of the population would report waiting to visit a doctor if they had specific symptoms, and if they were associated with low awareness of these symptoms as indicative of cancer.
Recognition of cancer warning signs in adult UK population (2013)

Awareness and recognition of symptoms of ovarian cancer were explored in the general population. Lower awareness of these symptoms was reported when the symptoms related to eating difficulties and changes in bladder or bowel habits.
Ovarian cancer symptom awareness (2014)

This study reports on the responses of the ABC survey from around 2,000 participants in New South Wales. The authors report misunderstanding about the use of screening tests for bowel cancer, with many respondents incorrectly believing screening should only occur when experiencing symptoms.

Beliefs about bowel cancer screening in New South Wales (2014)

The ABC survey responses from around 3,000 members of the Danish general population was assessed. The authors report finding a strong socioeconomic gradient in cancer awareness, suggesting targeting and tailoring of public health messages to this group.
Danish cancer awareness (2014)

Respondents in Denmark were most likely to report ‘worry about what the doctor might find’ and ‘worry about wasting the doctor’s time’ as reasons for not going to see their doctor. The authors found having a lower socioeconomic background was associated with negative cancer beliefs.
Barriers to healthcare seeking in Denmark (2014)

Cancer outcomes in Denmark and Sweden were shown to be different in the original ICBP cancer survival benchmark, yet the neighbouring countries have similar healthcare systems, economies and culture. The study supports previous findings of modest public awareness to many established cancer risk factors.
Awareness of risk factors in Denmark and Sweden (2014)

There are differences in cancer survival outcomes between Sweden and Denmark, with Sweden having higher survival for breast, colorectal and lung cancers. The authors report a higher symptom awareness and shorter anticipated delay in Denmark, which does not explain survival differences between jurisdictions.
Awareness of symptoms in Denmark and Sweden (2015)

The responses from members of the general public surveyed with the ABC tool were compared for Denmark, Sweden, Norway and Northern Ireland. The authors in particular wanted to understand awareness of risk factors and symptoms of malignant melanoma. They report low awareness of ‘sunburn in childhood’ as a risk factor and differences across jurisdictions in awareness.
Awareness of sunburn in childhood, sunbed use and change of moles (2015)

An analysis of the almost 7,000 respondents in participating UK nations (England, Wales and Northern Ireland) showed that smokers held more pessimistic beliefs about cancer. This is important as it means people who smoke may be less likely to go to their doctor when they have symptoms.

Effect of smoking on beliefs about cancer in the UK (2015)

Socioeconomic differences in positive and negative attitudes towards cancer were compared in respondents from England, Wales and Northern Ireland. There was strong agreement across all respondents towards the positively framed statements in the survey, but differences across socioeconomic groups in the negatively framed statements.

Socioeconomic inequalities and attitudes towards cancer in the UK (2015)

The Awareness and Beliefs about Cancer measure has been translated into several languages, including Danish. The authors report validity testing exercises and analyses carried out to confirm the Danish ABC is accepted and understood by the target audience – the Danish general population.
Measurement properties of Danish ABC measure (2017)

The authors compared the relationship between reported barriers to attending primary care and anticipated help seeking (how long respondents said they would wait before going to visit their doctor) for ICBP cancer types. They found that respondents associated barriers to a longer wait to visit their doctor, meaning more work should be done to understand why people put off going to their doctor.
Perceived barriers to clinical presentation (2017)

Responses from the general population in Denmark who participated in the original study were compared based on whether they, or someone close, had been diagnosed with cancer, or not at all. The authors suggest that cancer beliefs are impacted by a person’s experience of cancer and negative beliefs should be addressed and reframed within populations.
Cancer beliefs in cancer survivors, relatives and people with no experience of cancer (2017)


In order to assess how comparable ICBP healthcare systems are, the authors compared several characteristics of the participating jurisdictions. They found many similarities but also differences in centralisation, patient movement, access to secondary care and list systems.
How might healthcare systems influence speed of diagnosis (2014)

In order to explore differences in the readiness of primary care physicians (PCPs) to investigate for cancer, an online survey was developed. The survey asks a set of direct questions about the health system the PCP operates in, as well as five clinical scenarios asking how they would manage the patient.
Development of survey instrument to investigate primary care (2014)

Almost 2,800 primary care physicians (PCPs) took part in an online survey to understand how they would manage patients presenting with symptoms (if they would investigate or refer). These responses were then compared to 1- and 5-year survival across jurisdictions and studied ICBP cancer type.
Role of the primary care context in cancer survival (2015)


When surveys were sent to primary care physicians in New South Wales, Australia, different incentives were given in order to increase the response rate. The local team then analysed the impact of the different incentives on the response rate, and recommend which is the most cost-effective.
Unconditional vs conditional incentives and survey response rates in NSW (2014)

This paper explores whether cancer guidelines and adherence to them by primary care practitioners (PCPs) differs between participating jurisdictions. The authors also explore if the guidelines impact on how likely the PCP is to act on presenting cancer-related symptoms.

Variation in international adherence to referral guidelines (2016)

Primary care physicians in Manitoba, Ontario and British Columbia (Canada) all took part in this research, and so the local team compared their responses to the survey. The explore differences in access to diagnostic tests and wait times for results across provinces.
Primary care access to and wait times for cancer diagnostics (2016)

The core survey was also carried out by primary care practitioners in New Zealand, to understand the context in which these doctors work, their access to tests, and how they would respond to patients presenting with symptoms.
Investigations and referral in primary care in New Zealand (2017)


To understand how patients move through their cancer journey, internationally validated surveys were sent to recently diagnosed breast, colorectal, lung and ovarian cancer patients and their doctors. The surveys asked questions about when symptoms were first noticed, which tests patients received and when.
Methods for an international investigation of routes to cancer diagnosis (2016)


The surveys used in previous research exploring the patient’s cancer journey included free text questions These questions invited patients to describe their experience of being diagnosed with cancer within their health system, in this case Wales.
Patient perspectives on delays in diagnosis and treatment of cancer in Wales (2016)


It is thought that patients who die shortly after a cancer diagnosis may be more likely to be living with one or more health conditions (comorbidities) which could affect their chances of surviving. This is the first study to try to make international comparisons of commonly used measures of comorbidity derived from routine, population-based administrative health datasets for lung cancer patients.

Comorbidity measures from routine health datasets (2017)

This ICBP study found that in the incidence of colon and rectal cancer in adults younger than 50 years has increased substantially over the latest available 10-year period in several high-income countries, going against a decline or stabilisation trend in the incidence of colorectal cancers within the overall populations of high-income countries.

Changes in colorectal cancer incidence in seven high-income countries: a population-based study (2019)

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