Although the UK’s cancer survival rates have improved over the past two decades, in some cases a great deal, they still lag behind those in equivalent high-income countries, according to a report from Cancer Research UK. Authors of the analysis*, which is published in Lancet Oncology, warned that unless the UK addresses its shortage of appropriately trained NHS staff, there will be none of the necessary improvements in diagnosis and treatment access to achieve world-class cancer outcomes.
The researchers analysed data on more than 3.9 million cancer cases that were diagnosed from 1995 to 2014 in the UK and six comparable countries – Australia, Canada, Denmark, Ireland, New Zealand, and Norway – and compared mortality, incidence and survival rates for cancers of the oesophagus, stomach, colon, rectum, pancreas, lung and ovary. They said theirs is the first international study to have compared these three key measures.
They reported that there was much encouraging news. For example, for all of these cancer sites, both one- and five-year survival improved over the two decades studied.
For rectal cancer, five-year survival soared by 14 percentage points, from 48% to 62%; and five-year survival for colon cancer rose over the 20 years by nearly 12 percentage points, which was one of the highest increases in survival rates of all countries studied. They suggested that this could potentially be attributed to treatment advances, such as better surgery, and to other factors.
Furthermore, one-year survival for lung, ovarian and oesophageal cancer in the UK all improved by about 15 percentage points over the past 20 years.
However, they warned that despite this “great progress”, the UK is still near the bottom of the rankings “and has not yet caught up with other countries”.
Author John Butler, consultant surgeon at the Royal Marsden and clinical adviser at Cancer Research UK, commented: “There isn't one specific reason why survival in the UK has improved – it’s a combination of many different factors. Over the last twenty years we’ve seen improvements in cancer planning, development of national cancer strategies and the rollout of new diagnostic and treatment services.”
He explained: “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.”
The charity welcomed the progress in some areas, but said its analysis showed there was certainly still room for improvement. Its director of early diagnosis Sara Him said: “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.”
*Arnold M, Rutherford MJ, Bardot A, et al. Progress in cancer control: survival, mortality and incidence in seven high-income countries 1995-2014. Lancet Oncology, published online 11 September 2019. DOI: 10.1016/S1470-2045(19)30456-5