BMJ 2000;320:895-898 ( 1 April )

Papers

How many deaths have been avoided through improvements in cancer survival?

Editorial by Dickinson

M A Richards, Sainsbury professor of palliative medicine, ^a D Stockton, senior statistician, ^b P Babb, epidemiologist, ^c M P Coleman, head of cancer and public health unit. ^d

^a Department of Palliative Medicine, St Thomas's Hospital, London SE17 7EH, ^b Cancer Surveillance Group, Scottish Cancer Intelligence Unit, Information and Statistics Division, Trinity Park House, Edinburgh EH5 3SQ, ^c Demography and Health Division, Office for National Statistics, London SW1V 2QQ, ^d Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT

Correspondence to: M P Coleman m.coleman{at}lshtm.ac.uk

Objective: To estimate how many deaths from cancer have been avoided in England and Wales because of recent improvements in survival.
Design: Analysis of national statistics.
Setting: England and Wales.
Subjects: 1.5 million adults with diagnosis of one of 47 different cancers during 1981-5 or 1986-90.
Main outcome measures: Reduction in number of cancer deaths within five years of diagnosis among patients with cancer diagnosed during 1986-90 compared with patients with cancer diagnosed during 1981-5.
Results: 17 041 deaths were avoided within five years of diagnosis among patients with cancer diagnosed during 1986-90. This represents 3.3% of the cancer deaths that would have been expected if survival had been the same as for patients with cancer diagnosed during 1981-5. Two thirds of the avoided deaths arose from improvements in survival for just five cancers: female breast cancer (4822), cancers of the colon (2560), rectum (1090), and bladder (1157), and melanoma of the skin (1098). The largest proportionate reductions in excess deaths were for melanoma of the skin (23%) and cancers of the testis (17%) and bone (17%). About 12 000 (70%) of the avoided deaths arose among adults aged under 75 at death. Improvements in survival from cancers of lung, prostate, stomach, ovary, and brain were small: they accounted for 33% of all cancers but only 11% of avoided deaths.
Conclusions: Small gains in survival from common cancers save more lives than larger gains for uncommon cancers. If recent rates of improvement in cancer survival continue, about 24 000 deaths within five years of diagnosis would be avoided in patents aged under 75 by the year 2010, representing about a quarter of the government's overall target of 100 000 fewer cancer deaths.

---

© BMJ 2000
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Efficacy, safety, and cost of new anticancer drugs

Hilary Calvert, Duncan I Jodrell, James Cassidy, Adrian L Harris, Andrea Messori, Sabrina Trippoli, Monica Vaiani, Silvio Garattini, and Vittorio Bertele'
BMJ 2002 325: 1302. [Extract] [Full Text]

Survival and reduction in mortality from breast cancer

Michael Baum, H Gilbert Welch, T M Reynolds, A S Wierzbicki, Anthony G Threlfall, Stuart Collins, Ciaran B J Woodman, Michel P Coleman, Diane Stockton, Penny Babb, and Mike Richards
BMJ 2000 321: 1470. [Extract] [Full Text]

The NHS: last act of a Greek tragedy?
BMJ 2000 320: 0. [Full Text] [PDF]

The NHS: last act of a Greek tragedy?
BMJ 2000 320: 0. [Full Text] [PDF]

Trends in cancer deaths are not heading towards government target
BMJ 2000 320: 0. [Full Text]

Cancer trends in England and Wales

Heather O Dickinson
BMJ 2000 320: 884-885. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Walker, A. R P, Adam, F. I, Walker, B. F (2004). Breast cancer in black African women: a changing situation. The Journal of the Royal Society for the Promotion of Health 124: 81-85 [Abstract]  
• Boyle, P., d'Onofrio, A., Maisonneuve, P., Severi, G., Robertson, C., Tubiana, M., Veronesi, U. (2003). Measuring progress against cancer in Europe: has the 15% decline targeted for 2000 come about?. Ann Oncol 14: 1312-1325 [Abstract] [Full text]  
• Andreev, E. M, Nolte, E., Shkolnikov, V. M, Varavikova, E., McKee, M. (2003). The evolving pattern of avoidable mortality in Russia. Int J Epidemiol 32: 437-446 [Abstract] [Full text]  
• Bahadur, G., Ling, K.L.E., Hart, R., Ralph, D., Wafa, R., Ashraf, A., Jaman, N., Mahmud, S., Oyede, A.W. (2002). Semen quality and cryopreservation in adolescent cancer patients. Hum Reprod 17: 3157-3161 [Abstract] [Full text]  
• Calvert, H., Jodrell, D. I, Cassidy, J., Harris, A. L, Messori, A., Trippoli, S., Vaiani, M., Garattini, S., Bertele', V. (2002). Efficacy, safety, and cost of new anticancer drugs. BMJ 325: 1302-1302 [Full text]  
• Hollings, N., Shaw, P. (2002). Diagnostic imaging of lung cancer. Eur Respir J 19: 722-742 [Abstract] [Full text]  
• van Klaveren, R.J., Habbema, J.D.F., Pedersen, J.H., de Koning, H.J., Oudkerk, M., Hoogsteden, H.C. (2001). Lung cancer screening by low-dose spiral computed tomography. Eur Respir J 18: 857-866 [Abstract] [Full text]  
• Bahadur, G., Whelan, J., Ralph, D., Hindmarsh, P. (2001). Gaining consent to freeze spermatozoa from adolescents with cancer: legal, ethical and practical aspects. Hum Reprod 16: 188-193 [Abstract] [Full text]  
• Baum, M., Welch, H G., Reynolds, T M, Wierzbicki, A S, Threlfall, A. G, Collins, S., Woodman, C. B J, Coleman, M. P, Stockton, D., Babb, P., Richards, M. (2000). Survival and reduction in mortality from breast cancer. BMJ 321: 1470a-1470 [Full text]  

Rapid Responses:

Read all Rapid Responses

Failures of surgical care and outcome from cancer surgery

Richard G Fiddian-Green
bmj.com, 31 Mar 2000 [Full text]

Cancer Survival: Not all is as it seems

Tim Reynolds
bmj.com, 26 Apr 2000 [Full text]

Are 'avoided' deaths useful for predicting mortality reductions from cancer?

Anthony G Threlfall
bmj.com, 26 Apr 2000 [Full text]

Fallacy of 5-year survival

H Gilbert Welch
bmj.com, 5 May 2000 [Full text]

Online poll

Find out more here>> and here>>