Cancer survival lower than average
Survival rates for nine out of 10 common cancers are lower than the European average in the UK, despite rapid improvements in diagnosis and treatment since the end of the 1990s, a major study has shown.
Data from more than nine million adult patients reveals a disappointing picture of five-year survival for UK patients who started receiving treatment for cancer between 2000 and 2007.
In most cases survival was lower than the average for more than 20 European countries, including some former Soviet block states with exceptionally poor records such as Bulgaria.
Cancer survival in the UK lagged well behind Scandinavian countries with the best results such as Sweden, Norway and Finland.
The Eurocare-5 study compared five year survival for stomach, colon, rectal, lung, melanoma skin, breast, ovarian, prostate, and kidney cancers as well as the blood cancer non-Hodgkin lymphoma.
Figures for the UK and Ireland were better than average for just one cancer, melanoma, showing an 85.6% survival rate compared with a European mean of 83.2%. For every other cancer, patients in the UK had a lower than average chance of being alive after five years.
The main reason for the UK not doing better appeared to be delayed diagnosis, resulting in cancers not being treated until they had reached an advanced stage and leading to especially poor survival rates for older patients.
Compared with the rest of Europe, the UK and Ireland had the lowest survival rates for the oldest patients in their seventies and eighties.
Ciaran Devane, chief executive of leading cancer patient charity Macmillan Cancer Support, said: " This is truly depressing. One in two of us will get cancer in our lifetime so this is a big deal and has to be a wake-up call for the NHS.
"There is no reason why the UK should lag behind the rest of Europe when it comes to either certain cancers or survival rates for older cancer patients."
Sara Hiom, director of early diagnosis at Cancer Research UK said: "This study confirms that we need to do much more to ensure more patients survive their cancer."
As an example, five year survival for breast cancer in the UK and Ireland was 79.2% compared with 84.7% in Northern Europe and a European average of 81.8%.
In comparison, 86% of women in Sweden, 85.7% in Iceland, and 87.2% in Iceland lived five years after diagnosis.
For prostate cancer the figures were: UK and Ireland, 80.6%, Northern Europe, 85%, and the European average, 83.4%.
Comparable results for colon cancer were 51.8%, 59% and 57%, for melanoma, 85.6%, 87.7% and 83.2%, and for non-Hodgkin lymphoma 57.4%, 63.3% and 59.4%.
Stomach cancer survival was 17.2% in the UK and Ireland compared with a European average of 25.1%. Survival rates for rectal cancer were: UK, 53.7%; European average 55.8%, for lung cancer, UK, 9%; European average 13%, and for kidney cancer, UK, 47.6%; European average 60.6%.
The worst survival rates were seen in Eastern European countries, though the gap between east and west was closing, according to the study authors.
In these countries, which included Bulgaria, the Czech Republic, Estonia, Latvia, Lithuania, Poland and Slovakia, 49% of colon cancer patients survived five years. Eastern European survival rates for melanoma were 74%, for breast cancer 73.7%, for prostate cancer 72%, for lung cancer 10.6%, and for non-Hodgkin lymphoma 49.7%.
The comparisons between countries mask an overall improvement in cancer survival throughout Europe during the first decade of the 21st century, due to better diagnosis and treatment.
For all cancers, average five year survival rose significantly from 56.4% in 1999-2001 to 60.5% in 2005-2007.
Especially large increases were seen for prostate and rectal cancers, and non-Hodgkin lymphoma.
Italian researcher Dr Roberta De Angelis, from the Instituto Superiore di Sanita in Rome, who co-led the study published in the journal The Lancet Oncology, said: "The good news is that the number of adults surviving for at least five years after diagnosis has risen steadily over time in all European regions, reflecting major advances in cancer management such as organised cancer screening programmes and improved treatments. But there continues to be big disparities between countries, and international survival differences are narrowing for only a few cancers such as breast, rectum, prostate, and melanoma of the skin."
Sean Duffy, national clinical director for cancer at NHS England, said: "These reports show that we are making real inroads into improving cancer survival in England. For example, the improvement in survival in lung cancer has been dramatic over the last 20 years with almost twice as many patients alive a year after diagnosis now as was the case in 1990 and we can see that for melanoma (skin cancer) that the survival for England (85.3%) is better than the European average. I think this reflects a combination of the better organisation of cancer services, the availability of better treatments and earlier diagnosis.
"Our one-year survival figures show that for both of these cancers we are now approaching the outcomes of other countries where survival has historically been significantly better than in England. However, we want the best outcomes for all cancer patients and we know that we need to build on the improvements that have been made and do much more."
Di Riley, head of Public Health England's (PHE) National Cancer Intelligence Network, said: "The results from Eurocare-5 and our own studies suggest that we need to raise awareness especially amongst older people and encourage them to present earlier to GPs. "
Mark Flannagan, chief executive of the charity Beating Bowel Cancer, said: "We know that over 90% of cases of bowel cancer are treatable when caught at an early stage, so it's vital that we get better at early diagnosis. "