Incidence worse due to ageing Scots population

ALTHOUGH the number of people dying from cancer in Scotland is higher than ever, this is due to Scotland’s ageing population driving up the rate of incidence. Total annual cases rose by 8.4% between 2007 and 2017. However, over the same period mortality rates fell by 10% as detection and treatment improved.

Five-year survival, averaged across all age groups, sexes and deprivation categories, has also climbed in Scotland from 35% for patients diagnosed between 1987 and 1991, to 51% between 2007 and 2011.

Nonetheless, UK cancer survival rates continue to lag behind other European countries where healthcare spending as a proportion of GDP is generally higher. A 2017 report by the Swedish Institute for Health Economics found that France, Denmark, Austria and Ireland were spending more per person on cancer services than the UK, with Germany spending almost twice as much per head.

Five-year survival rates for patients diagnosed with nine of the most common cancers between 2000 and 2007 were lower in the UK than the European average. Survival rates for breast cancer were a decade behind countries including France and Sweden, the UK was second only to Bulgaria for the worst five-year survival rates for lung cancer, and on five-year survival for bowel cancer the UK rated 52% compared to 58% for the European average.

Recent figures have also highlighted the strain on Scotland’s cancer diagnosis services. The percentage of patients beginning treatment within 62 days of an “urgent referral with a suspicion of cancer” has declined to an all-time low of 81.4%, far short of the 95% target. Once patients are diagnosed and a decision is taken to treat their cancer, however, the average wait is just six days and 95% of patients are waiting no more than 31 days.

This emphasises that the backlog overwhelmingly affects processes involved in diagnosis. Demand for colonoscopies to diagnose bowel cancer is far outstripping resources and in regions such as Lothian, 70% of patients are waiting longer than six weeks for an examination. Acute shortages of radiologists to analyse CT and MRI scans are another major factor behind delays, especially in the north of Scotland where more than one in five cancer patients is now waiting longer than 62 days from referral to treatment.

The Scottish Government has unveiled an £850 million plan to drive down waiting times with a deadline to meet the referral-to-treatment targets by 2021.