London School of Hygiene & Tropical Medicine

Researchers from the London School of Hygiene & Tropical Medicine compared survival for colon, breast, lung, ovarian, rectal and stomach cancers in England, Australia, Canada, Denmark, Norway and Sweden between 1995 and 2009, and survival trends in England up to 2012. The study included more than 1.9 million cancer patients in England and another 1.9 million cancer patients from the other five countries.

Of all six countries, cancer survival was lowest in England overall, while Australia and Sweden had the highest cancer survival overall.

Compared with the better performing countries - Australia, Canada, Norway and Sweden - five-year survival was five to twelve per cent lower in England across all the cancer types measured (for patients diagnosed between 2005 and 2009).

Cancer survival in Denmark was generally better than in England in 2005-2009, except for one-year survival of stomach cancer and five-year survival of stomach and breast cancer where England performed similarly.

Despite this England's survival continues to improve, in some cases faster than elsewhere. Five-year survival from breast cancer improved more in England than in the four leading countries. And survival for all cancers except ovarian improved faster in England than Australia (comparing patients diagnosed during 2005-2009 with those diagnosed in 1995-1999).  

The faster improvements in survival could be down to the fact that there was more to be done to improve survival in England - diagnosing patients earlier and making sure more people can be given the best treatments - than in the countries that already had higher cancer survival.

Recent years have seen important increases in survival from some cancers. For example, while there was little or no change in five-year survival from lung cancer up to the mid-2000s in England, there has been steady improvement since then, up to one per cent per year during 2010-2012.

Lead author Dr Sarah Walters, from the Cancer Survival Group at the London School of Hygiene & Tropical Medicine, said: "The way England's cancer survival has improved shows promise, but it's vital that more is done to ensure England closes this gap and that more people survive cancer for longer. The rapid improvements we've seen over the past 20 years have been driven by better investment, setting and measuring targets within the NHS, and developing new ways to diagnose and treat cancer. If we are to improve further it is vital we continue to work on these areas."

Sara Hiom of Cancer Research UK, who were the funders of the study, added: "Not only is England struggling to excel on an international level - there's also too much variation across the country in the speed with which patients are diagnosed and whether they can get the treatments they need. The good news is that it seems previous improvements - in cancer awareness, services and treatments - mean we're now seeing some improvements in survival. But we must do more of what we're learning works. This means providing world-class funding for our cancer services and these services working together more effectively, if we want to achieve world class cancer survival."

Data from a separate study conducted by researchers from the School's Cancer Survival Group has also been included in a new Cancer Atlas by the American Cancer Society. Using data from the CONCORD-2 study, published in The Lancet in November 2014, the interactive atlas shows five-year survival for breast, cervical, colon and stomach cancers, and childhood acute lymphoblastic leukemia.

Publication

• Walters et al. Is England closing the international gap in cancer survival? British Journal of Cancer. DOI: 10.1038/bjc.2015.265