UK lags behind in European cancer survival rates » Health » 24dash.com

Britain is lagging behind as cancer survival rates improve throughout Europe, a major study shows today.

Eurocare-4, the largest investigation of its kind, analysed survival data for 2.7 million patients from 23 European countries diagnosed between 1995 and 1999.

The study compared five-year survival rates for eight common cancers.

It found that, overall, rates were improving and gaps between rich and poor countries narrowing.

But the news from the UK was not so good.

Survival in Britain remained below average, and was similar to that of some eastern European countries which spent less than a third of what the UK does per head on health care.

The findings led the journal which published the results to deliver a crushing verdict on the Department of Health's cancer plan, developed to tackle cancer in England.

In an editorial, The Lancet Oncology said: "Has the cancer plan worked? The short answer is seemingly no."

The international Eurocare team, led by Dr Franco Berrino, from the National Tumour Institute in Milan, Italy, gathered data from 83 cancer registries.

In the first five years after diagnosis, the total number of cancer deaths was 1.3 million, with an overall survival rate of 51.9%.

Bowel cancer had a survival rate of 53.8%, lung 12.3%, breast 78.9%, prostate 75.7%, ovarian 36.3%, melanoma (skin cancer) 81.6%, testis 94.2%, and Hodgkin's disease 80%.

For the first five cancers, survival rates were highest in Nordic countries, apart from Denmark, and central Europe, intermediate in southern Europe, lower in the UK and Ireland, and worst in eastern Europe.

Survival rates of the last three cancers varied little between different countries.

Countries with higher health care expenditure generally had better survival. But the UK and Denmark both had lower levels of all-cancer survival than other countries whose spending was similar to theirs. In contrast, Finland had high survival rates despite only moderate health expenditure.

A positive sign was that the marked international survival differences highlighted by previous Eurocare reports were not so evident.

The authors wrote: "Our new findings showing that the gap in cancer survival in Europe is narrowing is encouraging, and suggests substantial improvement in cancer care in countries with poor survival."

However survival was still much worse in eastern than in western Europe. And within western Europe, Britain and Denmark's records were relatively poor for several cancers.

Five-year breast cancer survival was around 83% in Finland and Sweden, 82% in France and Italy, 81% in the Netherlands, but only about 77% in Britain and Denmark.

For bowel cancer, five-year survival was above 57% in Nordic countries and several central and southern European populations, but 51% in the UK and 49% in Denmark.

A second Eurocare paper published in the same journal looked at the survival of patients diagnosed in 2000-02, and compared it with that of cancer patients in the US.

American patients fared much better. For those with solid tumours, overall five-year survival was 66.3% for men and 62.9% for women in the US compared with 47.3% and 55.8% in Europe.

In its editorial, The Lancet Oncology said: "Overall, survival for all cancers in England is lower than the European average. In other parts of the UK, survival for melanoma and for colorectal (bowel), lung, breast ovarian and prostate cancer is also lower than the European average, and in some cases among the lowest in Europe. Overall, survival for all cancers combined in the UK as a whole is not only below the European average, it is also noticeably similar to some eastern European countries that spend less than one third of the UK's per capita healthcare budget."

Nevertheless Professor Richard Sullivan, director of clinical programmes at Cancer Research UK, was upbeat about the findings, saying they showed "encouraging improvements for the UK".

He said: "While there are genuine differences in the early diagnosis and treatment of cancer patients between the UK and other European countries, the degree of that difference remains uncertain. Comparisons between countries are difficult because survival data are not collected in the same way in all places."

Contrasting with The Lancet Oncology editorial, he said the research showed that the NHS Cancer Plan was starting to have a positive effect.

However, Prof Sullivan said cancer was still not being diagnosed early enough in all cases, and it was important to ensure patients had access to "the best surgery, radiotherapy and other treatments".

He added: "This study shows that cancer is certainly not a 'ticked box'. We need a sustained effort to beat the disease."

Writing in the journal, the Department of Health's cancer "Tsar" Professor Mike Richards said the Eurocare report brought "welcome news of improvements in cancer survival.." and showed that "many more lives could be saved if the outcomes in all countries were brought up to the standards of the best countries".

He noted the fact that Britain and Denmark had lower survival rates than countries with similar health care expenditure.

Poor UK results from previous Eurocare studies had been attributable mainly to patients being diagnosed at a later stage than in other European countries, said Mr Richards.

"For policymakers, this conclusion is clearly of great importance, because it indicates that particular emphasis should be put on achieving earlier diagnosis," he added.

Copyright Press Association 2007

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