Cancer survival has continued to improve in England, but more needs to be done on early diagnosis and cancer treatments in the elderly, according to the results from the EUROCARE-5 study published today (Thursday 5 December 2013) in The Lancet Oncology.
EUROCARE-5 provides analyses of survival for over 10 million cancer patients diagnosed between 2000 and 2007, followed up to 2008. The project is based on data from 109 population-based cancer registries in 29 countries, and covers over 50% of the adult and 77% of the childhood European population.
Survival in England has been steadily increasing over the last 10 years, and this was confirmed in the latest ONS statistical release which includes patients diagnosed up to 2011. However, for certain cancers, England still fell behind other European countries.
According to the EUROCARE-5 study, survival in England was comparable to the European average for cancers of the breast, prostate, rectum and non-Hodgkin lymphoma, but lower than the average for cancers of the kidney, ovary and colon.
Survival is generally worse for the elderly in Europe, and this was particularly marked in England for cancers of the lung, rectum, melanoma, breast, stomach, prostate and kidney.
Late diagnosis contributes to poorer survival. For example, around a quarter of patients with colorectal cancers in England present as an emergency, usually at a late stage of disease resulting in a poor prognosis. This proportion rises to 43 per cent in patients aged 85 and over .
Di Riley, Head of PHE’s National Cancer Intelligence Network said:
These comparable data would not be possible without a comprehensive national cancer registration and intelligence system. Over the last year, alongside the improved quality of cancer registration, PHE’s National Cancer Intelligence Network has significantly improved cancer intelligence and this will allow us to better understand the reasons why some of our statistics are worse than other European countries.
We are working on the ‘Be Clear on Cancer’ campaign to raise public awareness of the early signs and symptoms of cancer. The results from EUROCARE-5 and our own studies suggest that we need to raise awareness especially amongst older people and encourage them to present earlier to GPs. The recently introduced bowel cancer screening programme should also improve survival from colon cancer, and reduce the number of emergency presentations of elderly people with bowel cancer, particularly as we are now screening people to their mid-70s. PHE is also doing a trial of extending breast screening for women in their 70s which should go some way to addressing the poorer survival of older women with breast cancer.
Sean Duffy, National Clinical Director for Cancer at NHS England said:
These comparative data are essential for monitoring our progress towards having the best outcomes for cancer in Europe. These reports show that we are making real inroads into improving cancer survival in England. For example, the improvement in survival in lung cancer has been dramatic over the last 20 years with almost twice as many patients alive a year after diagnosis now as was the case in 1990 and we can see that for melanoma (skin cancer) that the survival for England (85.3%) is better than the European average (83.2%) . I think this reflects a combination of the better organisation of cancer services, the availability of better treatments and earlier diagnosis.
Our one-year survival figures show that for both of these cancers we are now approaching the outcomes of other countries where survival has historically been significantly better than in England. However, we want the best outcomes for all cancer patients and we know that we need to build on the improvements that have been made and do much more.
Notes for Editors
EUROCARE-5 is publishing 2 papers in The Lancet Oncology, one on adult cancer survival across Europe, and the other on children. A copy of their media release and advance copies of the studies can be obtained by contacting The Lancet press office on 0207 424 4949 and firstname.lastname@example.org.
If you wish to link to the papers once they are published, please use the following links
In October this year, ONS published more up to date survival data from cancer in England, which includes patients diagnosed up to 2011. These show continued improvement in survival from cancer.
About the National Cancer Intelligence Network (NCIN), operated by Public Health England: The NCIN was established in June 2008 to coordinate the collection, analysis and publication of comparative national statistics on diagnosis, treatment and outcomes for all types of cancer. The NCIN is a UK wide partnership funded by multiple stakeholders. The NCIN will drive improvements in the standards of care and clinical outcomes through innovative uses of data. The NCIN will support audit and research programmes by providing cancer information and patient care will be monitored through expert analyses of up-to-date statistics. For more information please visit www.ncin.org.uk.
Public Health England’s mission is to protect and improve the nation’s health and to address inequalities through working with national and local government, the NHS, industry and the voluntary and community sector. PHE is an operationally autonomous executive agency of the Department of Health. www.gov.uk/phe. Follow us on Twitter @PHE_uk.
ONS Statistical Bulletin: Cancer Survival in England: Patient’s Diagnosed 2007-2011 and Followed up to 2012.
McPhail, S; Elliss-Brookes, L; Shelton, J et al, Emergency Presentation of Cancer and Short Tern Mortality; British Journal of Cancer (2013, 1-8)
Cancer survival in Europe 1999–2007 by country and age: results of EUROCARE-5—a population-based study