Survival of seven cancers is generally improving in the UK, but the overall level and pace of improvement is lower than for other countries, according to new study from The Lancet Oncology.
An observational study including 3.9 million cancer cases in seven high-income countries between 1995-2014, found that from 1995-2014, one- and five-year survival of seven cancers (oesophagus, stomach, colon, rectum, pancreas, lung, and ovary) improved in Australia, Canada, Denmark, Ireland, New Zealand, Norway, and the UK
For the latest period (2010-14), cancer-specific survival was generally higher in Australia, Canada, and Norway than in New Zealand, Denmark, Ireland, and the UK.
The authors say that the cancer stage at diagnosis, timely access to effective treatment, and co-occurring health conditions are likely the main determinants of patient outcomes, and future studies will be needed to assess the impact of these factors and better understand these international disparities.
Lead author Dr Melina Arnold of the International Agency for Research on Cancer (IARC) says: “As part of the SURVMARK-2 project and the second phase of the International Cancer Benchmarking Partnership (ICBP), we investigated incidence, one- and five-year survival, and mortality for seven cancers in seven countries over a 20-year period. While cancer survival and prognosis continue to improve across these high-income countries, the disparities we see are likely due to stage of the disease at diagnosis, the time it takes to get effective treatment and the effect of other concomitant health conditions.
“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."
Largest cancer survival improvements in patients under 75
The new study, by the International Cancer Benchmarking Partnership (ICBP – an international, multidisciplinary partnership of clinicians, academics and policymakers), calculated age-standardised survival at one and five years after diagnosis by site, age group, and period of diagnosis. They also mapped changes in incidence and mortality to changes in survival to assess progress in cancer control.
The largest improvements in survival were seen in patients diagnosed under the age of 75 years, compared to those aged 75 years and older, and for people who had cancers with a poor prognosis e.g. oesophagus, stomach, pancreas, and lung
The authors note several limitations, including that differences in how cancer registries collect data may affect the results, although considerable effort was made to ensure the data were comparable.
The percentage of cases eligible for analysis varied by country and depended heavily on the amount of cases identified by death certificate only, which were excluded from the analysis. Data from Canada and Australia were not national, though covered most of their populations – 76% and 70% respectively – thus the datasets are reasonably representative.