UK cancer survival rates lag 15 years behind other major countries
UK cancer survival rates are lagging 15 years behind other major countries because of a lack of chemotherapy and radiotherapy, research shows.
For the first time, experts at University College London examined the differences in treatment for eight cancer types across three continents.
They found cancer patients in the UK were far less likely than people in other countries to receive chemotherapy or radiotherapy.
Those who did receive it were forced to endure longer waits, while the disease was spreading.
The differences were most stark among older patients – with those in Canada seven times as likely to receive chemotherapy, compared with those in Britain.
Researchers said the lower rates of treatment in the UK helped explain why Britain’s cancer survival rates are 15 years behind those of comparable nations.
Across the countries examined, the UK was worst for cancer of the stomach, lung, colon and ovaries.
The UK five-year-survival rate for stomach cancer was just 20.8 per cent in 2010-14. This is lower than figures other countries achieved 15 years earlier. In 1995 to 1999 Australia had survival rates of 25.7 per cent, while Canada had 21.5 per cent, with 21.3 per cent in Norway.
Experts said NHS shortages of both staff and equipment meant patients were too often being denied treatment or waiting so long that it could no longer benefit them.
The studies, funded by Cancer Research UK and the International Cancer Benchmarking Partnership, published in the Lancet Oncology examined data from more than 780,000 patients in Australia, Canada, Norway and the UK diagnosed between 2012 and 2017.
In total, just 31.5 percent of cancer patients in the UK received chemotherapy, compared with 42.1 per cent in Australia, 38.5 per cent in Canada, and 39.1 per cent in Norway.
For radiotherapy, the UK figure was just 19.8 per cent, compared with 25.7 per cent in Canada, 23.9 per cent in Australia and 22.5 per cent in Norway.
Older patients fared particularly badly in the UK.
Just 2.4 per cent of UK patients aged 85 and over received chemotherapy, compared with 8.1 per cent in Australia and 14 per cent in parts of Canada.
Experts have also warned of “fatalistic” attitudes – especially towards older patients, and those with other health problems – with rushed consultations meaning that there was not enough time to explore treatment options.
Dr John Butler, clinical lead for the International Cancer Benchmarking Partnership and an ovarian cancer surgeon, said: “For many aggressive cancers – such as ovarian, lung and pancreatic cancer, it’s vital that people are diagnosed and start treatment as soon as possible.
“Lower use of chemotherapy and radiotherapy in the UK could impact people’s chances of survival, especially for older patients.
“Although we have made progress, the last benchmark showed that cancer survival in the UK is still around 10 to 15 years behind leading countries.
“This study captures missed opportunities for patients in the UK to receive life-prolonging treatment.”
Dr Butler said there were a number of likely factors behind the trend.
“In some cases it’s about patients being so unwell by the time they are diagnosed that they are not well enough to receive chemotherapy. And furthermore if there are long delays in the diagnostic pathway then that is more likely.”
He said the low rates could also reflect “nihilism” from some doctors, in assuming that the side effects of treatment were not worth the potential benefits, particularly in elderly patients.
The figures, which used international benchmarking data, tracking survival between 1995 and 2014, found that the UK figures were often on a par with other countries 15 years earlier.
For colon cancer, the UK’s rate of 58.9 per cent in 2010-14 was similar to those in Australia and Canada 15 years earlier.
Australia now achieves survival rates of 70.8 per cent for colon cancer, while Canada is at 66.8 per cent.
UK lung cancer survival, at 14.7 per cent, is similar to the rates in Australia and Canada 15 years ago. Latest benchmarking data has Australia at 21.4 per cent and Canada at 21.7 per cent.
Michelle Mitchell, chief executive of Cancer Research UK, said: “All cancer patients, no matter where they live, deserve to receive the highest quality care.
“But this research shows that UK patients are treated with chemotherapy and radiotherapy less often than comparable countries.
“When it comes to treating cancer, timing really matters. Behind these statistics are people waiting anxiously to begin treatment that is key to boosting their chances of survival.”
Prof Pat Price, a leading oncologist and chairman of the charity Radiotherapy UK, said the study showed “devastatingly” poor levels of access to treatment.
The co-founder of the Catch Up With Cancer campaign said: “A shortage of oncologists and front-line staff to deliver treatment, insufficient equipment, lengthy travel times, a negative approach to cancer care, particularly in the elderly, and an acceptance of variable and poor care in some parts of the country have all resulted in patients not receiving the treatment they need. This is simply not good enough for cancer patients and is costing lives.”
The study also compared trends within the UK. Take up of chemotherapy and radiotherapy was lowest in Northern Ireland and Scotland.
The studies also found the average time to start chemotherapy was 48 days in England, 65 in Scotland, 57 in Northern Ireland and 58 in Wales.
In New South Wales, Australia, the wait was lower at 43 days and 39 in Norway.
For radiotherapy, the UK fared even worse, with it taking 63 days to start treatment in England, 53 in Northern Ireland, 79 in Scotland and 81 in Wales.
In Alberta, Canada, the figure was 48 days and 53 days in British Columbia, while in New South Wales, Australia, it was 43 days.
An NHS spokesman said: “More people than ever are being diagnosed at an early stage of cancer and more treatment options are available – and over the last 12 months, nearly three million people received potentially life-saving cancer checks compared to 1.6 million in 2013.
“Whilst cancer survival is at an all-time high, it remains crucial for people to come forward and get checked if they have unusual symptoms – finding cancer earlier saves lives.”
A Department of Health and Social Care spokesman said: “These figures cover only the period from 2012-2017.
“Since then, we have made significant investment in cancer diagnosis and treatment, including £162 million towards radiotherapy equipment and £2.3 billion to launch 160 Community Diagnostic Centres across England, which will help us achieve our aim of catching 75% of all cancers at stage one or two by 2028.
“Cutting waiting lists is one of the Government’s top five priorities, and we have treated record numbers of patients over the last year.
“Survival rates are also improving across almost all types of cancer, and we will shortly legislate to create the first smoke-free generation – the biggest single public health intervention in decades.”
