Cancer survival – keeping pace with the rest of the pack

We need to make sure our cancer survival rates keep up with the rest of the world

With the Olympics now less than a year away, hopeful athletes throughout the world are training hard for London 2012.

In any major sporting event, underachieving teams try to look at all aspects of their performance to figure out how to improve.

Is it that the other team is faster? Or is there something that they are doing differently to give them the edge? By identifying, acknowledging, and addressing such issues, technique can be sharpened, and performance can be improved.

Sport isn’t the only area where England can improve by comparing its performance with other countries. Our cancer survival rates are also some way short of ideal, and compared with a number of countries throughout the developed world, England is lagging behind.

In January this year, the Government committed to achieving outcomes ‘comparable with the best in the world’, aiming to save an additional 5,000 lives every year by 2014/15.

But in order to save these extra lives, we need to know why we compare unfavourably – and what needs to be improved. A new report published today by the King’s Fund – a charity that aims to understand how our health system can be improved – aims to answer some of these questions.

How to improve cancer survival

The King’s Fund report examines why cancer survival rates are lower in England than in some other countries and identifies specific areas that need to be worked on.

It highlights the fact that compared with other countries:

• English patients are often diagnosed at a later stage
• In England there are delays in accessing treatment
• In this country evidence suggests that some older patients are being under-treated.

Interestingly, the review also shows that the availability of drugs is unlikely to be a significant cause.

So these are the areas that need to be worked on to improve our survival rates, to give our patients a sporting chance of receiving care that is equal to, or even better than, our best performing international neighbours.

Areas to improve

The review shows that England’s five year survival rates are improving for most types of cancer. For some of the most common cancers, however, survival is static, or in some cases has got worse compared with other countries, such as Sweden, Norway, Canada and Australia.

For example, the gap in survival rates for lung cancer between England and other countries has widened in recent years.

Lung, bowel and ovarian cancers account for around 65,000 new patients each year. Improving survival for these cancers would make a huge difference to a lot of people.

As we said this morning, there’s evidence that older people and deprived social groups are particularly disadvantaged by England’s poorer survival rates. For a start, older people are more likely to get cancer. But they are also more likely to be diagnosed later, to be under-treated and to experience worse outcomes. All these hurdles add up to mean that England’s survival rates lag behind the best in the world.

Achieving our goals

In identifying areas where England is underperforming, the review lays the foundation for a game plan to improve cancer survival, including:

• more patients must be diagnosed at an earlier stage (including through effective national screening programmes)
• access to high quality surgery and radiotherapy must be made more available throughout the country
• inequalities in the management of older people’s cancer must be tackled
• GPs need to use information about their referral rates and use of diagnostics to understand how their performance compares with others
• high-quality data collection, analysis and research must be used to monitor progress and identify which initiatives are effective at improving outcomes (something that the International Cancer Benchmarking Partnership is working on).

While this improvement in performance may not lead to the medals or new world records that many prospective Olympians will be hoping to achieve, it can ensure that outcomes for patients in England improve in line with the ambitions in the revised cancer strategy, and that English survival rates are comparable to the best performing countries in the world.

Harriet