UK lags behind comparable countries in cancer survival rates, study finds

The UK lags behind many comparable countries in cancer survival rates, according to a league table drawn up by leading international researchers, the first to draw a link between governments’ cancer strategies and the time people live after diagnosis.

Research published in The Lancet Oncology on Monday found Denmark, which in 1995 tied bottom with England for cancer survival, outpaced it over the next 20 years. The Nordic country showed among the highest increases in survival after maintaining a cross-party consensus on the policies and level of investment required.

Despite also experiencing big falls in mortality, England, where cancer policy and funding have been less consistent, did not improve at the same pace.

Michelle Mitchell, chief executive of Cancer Research UK, said “chronic underfunding and the worst staffing crisis in the NHS’s history” threatened to undermine progress.

She added that although England and Denmark had had similar outcomes for many cancer types in the late 1990s, “through robust, ambitious and consistent cancer policies — crucially underpinned by investment — Denmark has shot ahead of us”.

Ellen Nolte, a professor at the London School of Hygiene and Tropical Medicine who led the study, said it had found that “countries with cancer policies that are consistent over time are more successful in improving survival across a range of cancer types”. 

The weighted scores, taking into account both cancer policy consistency and survival times, showed Denmark at the top of the table, followed by Ontario in Canada and New South Wales in Australia, with Norway and Ireland also racking up similar above-the-mean scores. Scotland came next, followed by England, with New Zealand, Wales and Northern Ireland at the bottom — the last on the list by some distance.

The research was carried out by the International Cancer Benchmarking Partnership, which brings together policymakers, academics and clinicians from Australia, Canada, Denmark, Ireland, New Zealand, Norway and the four nations of the UK.

In New South Wales and Ontario, as well as in Denmark, cancer plans “built successively upon each other”, the researchers noted. Scotland, however, published four cancer plans between 2000 and 2016, with a clear change in emphasis between the 2004 and 2008 plans.

In England, a 2007 plan built on one from 2000, but a 2011 plan suggested a departure from previous strategies. The 2015 cancer strategy signalled a further change in direction, the report noted.

In England and Scotland, only the first cancer plan was accompanied by a specific blueprint for implementation, while Northern Ireland published only one cancer plan in the 20-year study period. By contrast, Denmark and Ontario had strategies that included “an explicit, detailed financial commitment to implementation”.

The researchers said their findings suggested that jurisdictions that scored higher on cancer policy consistency also largely showed significant improvements in five-year survival.

However, despite scoring lower than average on the constancy of its policies, England still showed marked improvements in five-year survival for most cancers.

Jesper Fisker, head of the Danish Cancer Society, credited “political consistency”, despite changes of government, as the key to his country’s improved survival rates.

“The entire public, the clinicians, the press, the patients’ organisations all agreed on the fact we needed to do something.”

“Massive investment” had followed, he added, enabling hospitals to buy more diagnostic equipment and patients to be given firm guarantees on how rapidly they would receive care at each stage of their treatment under “cancer pathways” established in 2007.

Mark Lawler, professor of digital health at Queen’s University Belfast and ICBP chair, blamed a lack of political leadership and a failure to prioritise spending on cancer for Northern Ireland’s performance.

He said the region, which came bottom of the new league table, could “still be brave, ambitious and visionary and essentially do a Denmark . . . but we need to do it quickly”.

The Department of Health and Social Care said it was “working at pace to improve outcomes for cancer patients across England, including by opening over 80 community diagnostics centres, which have delivered over 2mn additional scans, tests and checks”.

Record numbers of doctors and more than 9,100 more nurses were working across the NHS compared with last year “and we are on track to meet our commitment to deliver 50,000 more nurses by 2024”, it added

Northern Ireland’s Department of Health did not immediately respond to a request for comment.