THE BLOG

Before We Spend More on Cancer We Need to Spend More Wisely

25/03/2015 15:05 GMT | Updated 24/05/2015 10:59 BST

Are we spending too little on cancer? It would appear so from the latest grim analysis of European survival statistics which show Britain "stuck in the 1990s" and lagging behind our neighbours on breast, lung, colon and stomach cancer outcomes. Macmillan Cancer Support, which published its report this week, blames lack of resources along with late diagnosis and the British stiff upper lip that keeps people from bothering the doctor.

But throwing more money at cancer would, alone, be the wrong way to solve the problem. We need to spend more wisely, too. The UK spends over twice as much as Spain on colorectal cancer yet 61 per cent of patients in Spain survive five years compared with less than 54 per cent in the UK.

Why are we getting less bang for our bucks? Britain's five year survival rate for stomach, lung and kidney cancer is worse than much of eastern Europe, a group of nations facing markedly tougher economic conditions than our own. We need to understand the reasons for our poor performance before we throw more money at it.

Some of the answers are contained in a report by an expert group presented at the World Innovation Summit for Health (WISH) in Doha last month, which I chaired. It identified excessive spending in cancer care, not just in this country but globally, and described innovative projects aimed at re-directing resources to improve outcomes.

Cancer drug prices have risen at four times the rate of inflation, a rate that is hard to justify. There is evidence of doctors ordering unnecessary tests, over-treatment and needless use of expensive technology. Thousands of early stage breast cancers unlikely to cause harm have been diagnosed and treated unnecessarily in women - and the same is true of prostate cancer in men. Many terminal patients treated in hospital could be looked after at home - where most would prefer to be.

You might expect that the countries that spent the most on cancer care would have the best outcomes. But it isn't so. Spain, Germany and Australia have broadly the same five year survival rates for colorectal cancer but spend widely varying amounts on the disease. The cost per case ranges from 30,000 euros in Germany to 5,000 euros in Spain, a six-fold difference.

There were 331,000 new cases of cancer diagnosed in 2011 in the UK, and the number is projected to rise by more than half over the next decade driving up cancer costs at a time when the NHS is under unprecedented financial pressure.

The only way to help patients get the treatment they need is to ensure that every pound is used to the best effect. It would be a foolish nation that devoted extra resources to cancer care without first checking that this is so.

Lord Darzi is a surgeon, director of the Institute of Global Health Innovation at Imperial College London, and Executive Chair of the World Innovation Summit for Health, an initiative of Qatar Foundation. He was a Labour health minister from 2007-9.