UK still behind in cancer survival despite recent surge
Cancer survival rates in the UK have improved markedly over recent decades but still lag behind those of comparable countries, a major research exercise has shown.
The study looked at one-year and five-year survival of cancer patients in Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK between 1995 and 2014. It found that while the chances of surviving cancer have improved in the UK, they have not caught up with other countries, which are also doing better thanks to new technologies and efforts to catch the disease at an earlier stage before it becomes hard to treat.
Better surgery, in particular, led to a rise in five-year survival rates for colon cancer in the UK from 48% to 62%. Oneyear survival for lung, ovarian and oesophageal cancer all increased by about 15 percentage points over the 20 years. However, the UK fared worst of the countries examined in four of the seven cancers measured by five-year survival rates: rectal, pancreatic, lung and stomach.
John Butler, a co-author of the study and clinical adviser to Cancer Research UK, said: “There isn’t one specific reason why survival in the UK has improved – it’s a combination of many different factors. Over the last 20 years we’ve seen improvements in cancer planning, development of national cancer strategies and the rollout of new diagnostic and treatment services.
“For lung, ovarian and oesophageal cancer in particular, survival has increased largely because the quality of surgery has radically improved, and more surgery is taking place than before. More people are being looked after by specialist teams, rather than surgeons who aren’t experts in that area.
“But while we’re still researching what can be done to close the survival gap between countries, we know continued investment in early diagnosis and cancer care plays a big part. Despite our changes we’ve made slower progress than others.”
Cancer Research UK, which helped fund the study known as the International Cancer Benchmarking Partnership, said more NHS cancer staff were needed if the UK was to catch up.
“More people than ever before are surviving cancer thanks to research and targeted improvements in care. But while we’re on the right track, the numbers show we can certainly do better,” said Sara Hiom, the charity’s director of early diagnosis.
“We will not see the necessary improvements in diagnosis and access to treatment unless we have enough of the right staff across our NHS. Cancer Research UK has been calling for staff shortages to be addressed because, quite simply, it will give people a better chance of surviving their cancer.
“If we are to achieve world-class cancer outcomes in the UK, then we need to see comparable investment in the NHS and the systems and innovations that support it. It’s never been a more crucial time for the government to put new money where it matters.”
The study, published in the Lancet Oncology journal, looked at 3.9 million cancer cases across the seven countries. The researchers say the variations between countries are probably mostly to do with how early the cancer is diagnosed, whether the patient receives prompt treatment and whether they have other health problems at the same time.
Australia, Norway and Canada generally had better survival rates than New Zealand, Denmark, Ireland and the UK. In the most recent years with data available, between 2010 and 2014, Australia topped the five-year survival league table in five out of seven cancers – oesophageal (23.5%), stomach (32.8%), colon (70.8%), rectal (70.8%) and pancreatic (14.6%). In the latter two cancers, the UK had the lowest survival rates over five years, at 62.1% and 7.9%.
The UK was also last in lung cancer (14.7%), in which Canada did best (21.7%), and stomach cancer (20.8%). Ovarian cancer survival was highest in Norway (46.2%) and lowest in Ireland (36%).
The lead author, Dr Melina Arnold of the International Agency for Research on Cancer, said: “The improvements in cancer survival observed are likely a direct consequence of healthcare reforms and technological advances that enable earlier diagnosis, more effective and tailored treatment and better patient management.
“Improvements in surgical techniques and new guidelines including preoperative radiotherapy as well as better diagnosis and scanning, enabling better staging of cancers and selection for targeted therapies, have all improved patient outcomes.”
The trajectory over the two decades shows the UK improving but failing to catch other countries that are also improving. However, NHS England rejected the findings, claiming things have changed. “In the five years since the study’s research ends, cancer survival has actually hit a record high, thanks to improvements in NHS cancer services, including the introduction of revolutionary treatments like proton beam therapy and immunotherapy,” said a spokesperson.
“The NHS long-term plan will build on this progress by ramping up action to spot more cancers at the earliest possible stage when the chance of survival is higher, saving tens of thousands more lives every year.”