Controversy over European cancer statistics

Comparing international cancer statistics is tricky

It’s ‘Eurocare’ time again.

The publication of the flagship European report on cancer survival inevitably leads to the UK being described by the media as the ‘sick man of Europe’, and this week was no exception. The media almost universally portrayed the UK being ‘put to shame’ by the fact that we ‘lag behind’ many other European nations.

On the face of it, this seems justified. The report – a complicated mathematical model built out of figures collected many different ways in many different countries – does appear to show that the UK has a lower survival rate for some cancers.

And when you look at our healthcare expenditure compared with some of neighbours, the fact that we have lower cancer survival but a similar spend seems more than a little incongruous.

Of course, from a media point of view, this interpretation fits nicely into the prevailing narrative of alleged political mismanagement and the current political battle over the NHS.

But with all these stories, it’s about how you spin them. And digging deeper at the report, there’s a lot to cheer about in Eurocare-4, and we reported the story on our news feed with the headline “European cancer survival continues to improve“.

After several successive reports showing no change, the UK is now improving, and the European survival gap is narrowing. There is certainly a fair way still way to go, but Eurocare shows that many UK healthcare reforms guided by previous reports have begun to make a difference.

This brings us to another important point about Eurocare. Many of the patients included in the UK analysis received treatment in the early stages of, or before, reforms like the NHS Cancer Plan and Cancer in Scotland were implemented, and had had any chance to have an effect. So things are not only improving – they will continue to improve in the future.

This fact is borne out be the publication, on the same day, of the ONS cancer survival rates, showing a clear improvement in most cancers over the 1999-2004 period. But for some reason this didn’t make the headlines in the same way Eurocare did.

All this is Good News.

Now for the Bad Bits.

Even accounting for the problems with how the Eurocare data were collected, it is likely that cancer survival in the UK is not yet where it could, or should, be. And there are several possible reasons for this.

Chief among them is that there are indeed improvements to be made to deliver the right services to cancer patients in a timely and cost-effective manner. The reforms underway as a result of the Cancer Plan, and the government’s new Cancer Reform Strategy (being drawn up, with Cancer Research UK help, at the moment) are aimed at making this happen.

Another of the things the report (and the newspapers) highlighted is that late diagnosis – leading to poorer outcome – is an issue in the UK.

But although the successful breast and cervical screening programmes for several decades, the introduction of the national bowel cancer screening programme in 2006 should make a large impact.

And that’s why our Screening Matters campaign is so important. Early detection saves lives. And so it’s essential for all of us to attend cancer screening when invited, to nag our friends and relatives to go too, and to spread the word about body awareness. If you do one thing today, get a friend to sign our online petition and to join up to the campaign.

Anyway, back on the subject of the Eurocare studies – we published an article on News & Resources just after Eurocare-3 was published (again in response to ‘sick man’ reports), looking in detail at how the statistics were put together, and how they get (mis)interpreted. We’ve just updated it to account for this year’s data, and it’s well worth a read if you’re interested.

Henry