UK can­cer sur­vival rates still lag be­hind

The Guardian - - Front Page - Sarah Bose­ley Health ed­i­tor

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 had im­proved in the UK, they had 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%. One-year 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,” said Sara Hiom, the char­ity’s di­rec­tor of early di­ag­no­sis. “But while we’re on the right track, the num­bers show we can cer­tainly do bet­ter.

“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 3.9m 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 two decades shows the UK im­prov­ing but fail­ing to catch other coun­tries that are also im­prov­ing. 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,” it said.

“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.”

PHO­TO­GRAPH: KALLISTA IMAGES/COR­BIS

The UK was last in five-year lung can­cer sur­vival rates – at 14.7% – among com­pa­ra­ble coun­tries

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