Cancer survival data ‘encouraging’

An article in the Lancet Oncology represents the first study to assess the impact of the NHS cancer plan for England since its introduction in 2000. At that time, Britain had one of the poorest levels of cancer survival in Europe and the plan was designed to improve five-year survival rates so that England is on a par with the best in Europe by 2010. For the purposes of the latest study, Wales has been used to measure the effectiveness of the English cancer plan as it did not adopt its own plan until 2006. Researchers at the Cancer Research UK Cancer Survival Group at the London School of Hygiene and Tropical Medicine analysed both national and regional survival rates among 2.2 million adults diagnosed with 21 common cancers in England and Wales up to 2007. The figures show that one-year survival improved for most cancers in both England and Wales between 1996 and 2006. One-year survival improved slightly faster in Wales between 1996 and 2003 – a trend that is thought to be due to Welsh clinicians acting on recommendations contained in the Cameron report published in 1996 – but this trend was reversed after 2004. In England, survival trends have improved for cancers of the stomach, bowel, rectum, womb, ovary and kidney since 2001. However, there has been a fall in survival for bladder cancer, Hodgkin’s lymphoma and leukaemia. Three-year survival figures show no significant difference between England and Wales up until 2003. Since then, England has achieved a slightly faster increase in survival. However, the study authors note that despite overall improvements in three-year survival in England, there are still regional variations, with the more affluent southern regions tending to enjoy higher-than-average survival. They suggest that the improvements seen in England since 2004 may be related to the cancer plan and have called for further studies to investigate the impact of individual aspects of the cancer plan on survival, including reductions in waiting times and the creation of multidisciplinary teams. The researchers also note that predicted three-year survival for cancers diagnosed in 2007 in England are generally higher than for 2004-06, “suggesting that survival is likely to continue to increase”. “In contrast,” they note, “there are fewer predicted improvements in survival in Wales.” Overall, the team concludes that the findings “suggest some beneficial effect of the NHS cancer plan for England, although the data do not so far provide a definitive assessment of the effectiveness of the plan”. National cancer director for England Professor Mike Richards commented: “The good news from the study by Rachet and colleagues is that, for most cancers, survival has improved over the past decade in both countries,” he pointed out. “A plausible explanation... is that Wales moved forward faster in the early years as a result of the Cameron report, with England catching up and overtaking as a result of the cancer plan.” Sara Hiom, Cancer Research UK’s director of health information, said: “This is the first indication that the cancer plan could be moving cancer survival in the right direction. This is exciting news but we need to take a more indepth look to see which parts of the plan have had the most positive impact and which parts require more action. Survival rates will improve with earlier cancer diagnosis and it is encouraging to see these generally improving since 2000. We think around 5,000 extra deaths annually may occur in the UK because of delayed diagnosis. “Cancer Research UK is working with the Department of Health and National Cancer Action Team to further improve cancer survival and reduce mortality through the National Awareness and Early Diagnosis Initiative (NAEDI).”