Cancer Survival 'Still Lagging Behind Other Countries'

Peter Russell

November 27, 2018

A lack of diagnostic equipment and a shortage of staff to operate the machinery and report scan results are hampering England's ambition to close the 5-year cancer survival rate gap with the best in Europe, an audit has concluded.

The report by The Health Foundation identified other problems that need to be addressed, such as familiarising people with cancer symptoms so they are more likely to seek early medical intervention.

Unfinished Business of Cancer Survival Rates

The report, Unfinished Business , looked at progress in cancer care over 2 decades since the launch of the NHS Cancer Plan in 2000, which formed the first comprehensive national strategy for improving cancer care in England. The Plan noted that people with cancer had poorer outcomes than those in other European countries and promised that by 2010 'our 5-year survival rates for cancer will compare with the best in Europe'.

The report found progress had been made on reducing mortality, and improving the chances of survival and the experience of care, for cancer patients in England.

However, despite improvements, England's 5-year survival rates, and those of the rest of the UK, have not caught up with other comparable countries. With the exception of breast cancer, the gap has not narrowed, as other countries have also improved.

The report notes, for example, that a person diagnosed with colon cancer in the UK has a 60% chance of survival after 5 years, compared with 71% for those living in Australia.

Continuing failings were also noted in early disease detection, where the proportion of people being diagnosed with cancer at an early stage remained almost static between 2015 and 2017.

The report called for:

  • The NHS to make a significant investment in more diagnostic equipment and staff trained in its use. It found that the UK ranked 35th out of 37 countries for CT scanners, and 31st out of 36 for MRI scanners.

  • More support for GPs to refer patients suspected of cancer for diagnostic tests and sufficient primary care funding to keep up with the demand for appointments. This should enable the investigation of patients who have symptoms that indicate a 3% or higher risk of cancer, as recommended by NICE guidelines.

  • With recent research suggesting that 22% of people were worried about wasting a GP's time, the public needed to be more aware of cancer symptoms so they could seek help early and improve their chances of survival.

Recommendations on diagnostics included improvements to bowel cancer screening, offering low-dose CT scans for people at risk of lung cancer, and accelerating a programme of rapid diagnostic centres.

Cancer Care Aims 'Have Not Been Achieved'

Professor Sir Mike Richards, former National Cancer Director, who helped compile the report, said: "The NHS Cancer Plan in 2000 and all subsequent cancer strategies have set ambitions for England to match the best in Europe or the world in relation to cancer survival. 

"Although progress has been made on many aspects of cancer, these aims have not been achieved. Every year thousands of deaths could be avoided if we achieved these goals. This is the equivalent to a jumbo jet of people falling from the sky every 2 weeks."

The Department of Health and Social Care said cancer was a priority for the Government. A spokesperson said: "We have committed to delivering a new 28-day standard from April 2019, which will see patients with suspected cancer receive a diagnosis or have cancer ruled out within 28 days.

"We also announced a new cancer strategy last month that will radically overhaul the system and ensure 75% of all cancers are detected at an early stage by 2028."

Sir Mike commented: "The Prime Minister’s ambitious target to increase early detection of cancer from 1 in 2 people today, to 3 in 4 by 2028, is welcome, but if we are serious about moving the dial on early diagnosis, then setting targets and handing out money will not be enough. 

"The NHS must change the way that care is currently organised to make it easier for people to be seen and diagnosed as quickly as possible, as we know this gives them the best chance of survival."
 

Staff Shortages and Underfunding

Ruth Thorlby, assistant director of policy at The Health Foundation, said in a statement: "Although investment is clearly needed in workforce and equipment, the experience of the past 20 years in cancer shows that staff need support, evidence and skills to implement change. Without these, the injection of resources alone will not be effective."

In response to the report, Emma Greenwood, Cancer Research UKs director of policy, said: "Preventing more cancers and diagnosing people at the earliest stage are key to achieving world class cancer care. Every part of the health system has its part to play, particularly encouraging more people to seek advice when they have symptoms making sure more people are diagnosed early. 

"But the significant shortages in staff qualified to diagnose cancer remain a major barrier to progress and we must, as a matter of urgency, see a clear plan to boost the cancer workforce – backed up by vital investment - as part of the NHS long-term plan."
 

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