Why Are The UK's Cancer Survival Rates Lagging Behind Other Countries?

The UK has the poorest five-year survival rate for five out of seven cancers, including bowel and lung.

The UK sits at the bottom of a major league table for cancer survival in high-income countries, researchers have warned.

While survival rates are improving for patients across the UK, the country still performs worst for key cancers including bowel, lung and pancreatic.

Cancer Research UK, which oversaw the analysis published in the journal Lancet Oncology, said the government must correct staff shortages across the NHS and address late diagnosis.

The study looked at 3.9 million cancer cases between 1995 and 2014 in seven comparable high-income countries with universal healthcare: Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK.

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Positive improvements have been made.

The data covered seven cancers – of the oesophagus, stomach, colon (bowel), rectum, pancreas, lung and ovary.

It showed that cancer survival one year after diagnosis, and at the five-year mark, has improved across all seven types of cancer in the UK over the last 20 years.

For example, five-year survival for rectal cancer in the UK has risen by 14% since 1995, from 48% to 62%.

The UK also has one of the highest increases in five-year survival – almost 12% – across all countries for bowel cancer.

One-year survival for lung, ovarian and oesophageal cancer has also increased by around 15% in the last 20 years.

But the UK is still lagging behind.

Despite the increase in survival rates, the UK has still not caught up with other countries – and sits at the bottom of the league table for five out of the seven cancers.

Between 2010 and 2014, the UK had the lowest five-year survival rate for stomach cancer (20.8%), while Australia had the highest (32.8%).

Some 70.8% of patients in Australia lived for at least five years after diagnosis with bowel cancer, but the UK had the lowest survival rate at 58.9%.

Australia also had the highest survival (70.8%) for rectal cancer, while the UK had the lowest (62.1%).

Meanwhile, pancreatic cancer had the lowest five-year survival of all – ranging from 7.9% in the UK (lowest) to 14.6% in Australia (highest).

For lung cancer, Canada had the highest five-year survival (21.7%) while the UK had the lowest (14.7%).

Why is this happening?

The authors of the study said the differences between the countries could be partly explained by how quickly patients get a diagnosis and then prompt access to effective treatment.

Cancer Research UK’s clinical adviser, John Butler, who co-authored the study and is a consultant surgeon at the Royal Marsden Hospital in London, said 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,” he said. But he also called for continued investment in early diagnosis and cancer care.

Sara Hiom, Cancer Research UK’s director of early diagnosis, said staff shortages need to be addressed, because “quite simply, it will give people a better chance of surviving their cancer.”

A recent analysis by the Royal College of Nursing showed there were more than 1,400 cancer nurse vacancies in England alone in the six months to September 2018 – an increase of 16% on the previous year.

And data shows that three-quarters of NHS services are failing to treat cancer patients quickly enough. Hospitals are meant to start treatment within 62 days of an urgent referral by a GP in 85% of cases. But 94 out of 131 cancer services in England failed to do that during 2018-19 – compared with 36 five years ago, BBC analysis has found.

The government pointed to other data, however, which showed one-year survival rates for all types of cancer are at a record high. In England, one-year survival has increased from 62% in 2001 to 72.8% in 2016.

A Department of Health and Social Care spokesperson said: “Cancer survival rates are at a record high, but we are determined to go further and save even more lives.

“Through our NHS Long Term Plan, we will detect more cancers at an earlier stage, saving an estimated 55,000 lives a year. Alongside this, the record £33.9 billion extra a year we’re investing in our NHS will help support the health service in recruiting the staff it needs for the future.”

An NHS England spokesperson said the report was out of date – as the last figures collected were in 2014 – and pointed to the increase in one-year survival rates seen in England.

The spokesperson said this was “thanks to improvements in NHS cancer services, including the introduction of revolutionary treatments like proton beam therapy and immunotherapy”.