A comprehensive review of international evidence has concluded that performance in key areas of cancer care is worse in England than in other countries, resulting in comparatively poor survival rates for people with some of the most common forms of cancer.
The study examined why cancer survival rates in England lag behind other countries. It found strong evidence of later diagnosis, delays in accessing treatment and age bias, with older patients being under-treated. It also concluded that the availability of drugs is unlikely to be a significant factor in England’s comparatively poor performance.
Although five-year survival rates are improving overall for most types of cancer in England, the study confirmed that survival rates from some of the commonest cancers are static or even worsening compared to other developed countries including Canada, Australia, Sweden and Norway.
- The gap in survival rates for lung cancer between England and other countries has grown wider in recent years. Lung cancer is the second most common form of cancer in England, with about 30,000 people registered each year as being affected.
- Survival rates for colorectal and ovarian cancers continue to lag behind other countries. Together lung, colorectal and ovarian cancers account for around 65,000 new patients, or 26% of all cancers, registered in England each year.
- Survival rates are worse among older people and deprived social groups, who also have a higher incidence of cancer. Even though survival rates among all social groups are improving, this persistent disparity is growing wider.
- However, the study found that survival rates for breast cancer, the most commonly-diagnosed cancer in England, appear to be catching up with other higher-performing countries. About 83 per cent of women diagnosed with breast cancer survive for at least five years.
In January this year, the government committed to achieving cancer outcomes 'comparable with the best in the world' and England's comparatively poor outcomes were highlighted by ministers as part of their case for NHS reform. To improve survival rates in England, the study concluded that more patients must receive diagnosis at an earlier stage, including through effective screening programmes. In addition, timely and equal access to surgery and radiotherapy must be made more available, and inequalities in the management of older people's cancer must be tackled.
'England still has a way to go to reach cancer survival rates that are ranked with the best international performers. The evidence points to early diagnosis as being key to improving outcomes. We hope urgent priority is given to closing the gap in survival rates between different groups in society. We found that older people are particularly burdened by this, being more likely to have cancer, to be diagnosed later, to be under-treated and to experience worse outcomes'
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How to improve cancer survival: explaining England's relatively poor rates, is a literature review published jointly by The King's Fund and Cancer Research UK on Thursday 9 June at 00.01.
The International Cancer Benchmarking Partnership (ICBP) is a new initiative bringing together policy-makers, researchers and clinicians across six countries, initiated by the Department of Health in England and managed by Cancer Research UK. The ICBP is studying the differences in survival rates between countries and identifying the most important opportunities for improvement.
- Over 250,000 people in England are diagnosed with cancer every year and around 130,000 die from the disease. Currently, about 1.8 million people are living with and beyond a cancer diagnosis.
- Cancer survival rates measure the percentage of people who survive a particular type of cancer for a specific amount of time, often one or five years.
- The government's cancer outcomes strategy, published in January 2011, states that 'our aspiration is that England should achieve cancer outcomes which are comparable with the best in the world.' The NHS Commissioning Board will be held to account for progress.
- One-year and five-year cancer survival have been identified as areas for improvement in the NHS Outcomes Framework and 2011's cancer strategy commits to saving an additional 5,000 lives by 2015.
- If England was to achieve cancer survival rates equal to the European average, then 5,000 lives would be saved every year. If England was to achieve cancer survival rates equal to the European best, then 10,000 lives would be saved every year.
- The incidence of different cancers in England can be found on the Office for National Statistics website.
- The report's source for the statistics on international comparisons of cancer survival is a recent major study published in The Lancet in January 2011. This study was the first publication to come out of the work of the International Cancer Benchmarking Partnership. (The Lancet, vol 377, no 9760, pp 127–38.)
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