50% survive cancer for 10 years
Half of all cancer patients in England and Wales can now expect to survive at least 10 years after diagnosis, new research has shown.
Four decades ago, in the early 1970s, only a quarter of people with cancer were likely to live that long.
But the positive overall trend masks poor progress in the the fight against certain cancers. Even today, a mere 1% of pancreatic cancer patients manage to reach the 10-year survival mark.
Scientists led by the Cancer Research UK Cancer Survival Group in London analysed survival trends for more than seven million individuals aged 15 to 99 diagnosed with one of 21 common cancers in England and Wales between 1971 and 2011.
The cancers could clearly be divided into three groups, with high, moderate, or low survival. Which group a particular cancer fell in had remained basically the same for 40 years.
For cancers of the brain, stomach, lung, oesophagus, and pancreas, 10-year survival after diagnosis is still below 15%. For these diseases, there has been little or no improvement in long-term survival rates since the early 1970s.
Decade-long survival was seen in only 5% of people with lung cancer and 14% of brain tumour patients.
Lead researcher Dr Bernard Rachet, from the London School of Hygiene and Tropical Medicine, said: "These five cancers impose a huge public health burden, both because they are common and because they are often diagnosed at a late stage, when they are much harder to treat.
"For three of these cancers (lung, stomach, and oesophagus), surgery is often the key treatment, but patients are often diagnosed too late for surgery with a realistic prospect of cure. Even for those patients who are diagnosed early, surgery is not always performed.
"We should be carrying out surgical treatment for many more patients than is currently the case. When it comes to lung cancer, for example, almost all patients diagnosed at an early stage of disease should be operated on with curative intent."
There is better news for patients with many other cancers. Survival for 10 years or more is generally above 70% for people diagnosed with breast, prostate, testis, womb, and melanoma (malignant skin) cancers, as well as Hodgkin's disease.
In the case of breast cancer, more than three-quarters (78%) of patients are now living at least 10 years compared with 40% in the early 1970s.
For melanoma patients, 10-year survival has almost doubled from 46% to 90%.
Almost every man diagnosed with testicular cancer (98%) can now expect to live at least 10 years compared with 69% 40 years ago, said the researchers.
The findings, reported in medical journal The Lancet, expose a persistent age gap between younger and older patients.
"Even after we have adjusted for the fact that older people have much higher death rates from other diseases than younger people, elderly cancer patients are doing worse for all cancers," said Dr Rachet.
"This problem is particularly marked in the UK. In other countries, the age gap in cancer survival has become much narrower over the last 15 to 20 years than in England and Wales."
Co-author Manuela Quaresma, also from the London School of Hygiene and Tropical Medicine, said: "Although survival for some cancers has improved dramatically over the past 40 years, others are lagging far behind.
"More investment is urgently needed to improve early diagnosis and provide the best treatment, including more specialist surgeons, for poor-prognosis cancers like lung cancer, which have shown little or no evidence of improvement in long-term survival."
Dr Penny Woods, chief executive of the British Lung Foundation, said: " It is encouraging to see that there has been an increase in survival rates for most cancers in the last 40 years. However, it is deeply distressing that survival rates for lung cancer - the biggest cancer killer in the UK - continue to lag so far behind most other forms of the disease.
"This is a devastating consequence of late presentation and delayed diagnosis. People must be encouraged to get symptoms, such as a persistent cough and unusual breathlessness, checked out as soon as possible - it may be nothing, but being seen by a doctor earlier could really mean the difference between life and death."