Cancer survival in UK and Denmark lags behind that in Australia, Canada, and Sweden

BMJ 2010; 341 doi: (Published 22 December 2010) Cite this as: BMJ 2010;341:c7372
  1. Zosia Kmietowicz
  1. 1London

Late diagnosis means that patients in the United Kingdom and Denmark are less likely to survive bowel, lung, breast, or ovarian cancer than patients in Australia, Canada, and Sweden, a new study concludes.

The study of the records of 2.4 million adults who were given a diagnosis of one of the cancers between 1995 and 2007 found that patients were living longer in 2007 in all the six countries studied than they were in the late 1990s (Lancet, doi:10.1016/S0140-6736(10)62231-3). But survival rates were persistently higher in Australia, Canada, and Sweden, intermediate in Norway, and lower in Denmark and the United Kingdom (excluding Scotland), especially in the first year after diagnosis and in people aged over 65.

Many countries have implemented cancer plans since the later 1990s, including England (2000), Northern Ireland (1996), Wales (2004), and Denmark (2005), with the specific aim of improving survival.

The study was carried out by the International Benchmarking Partnership, a collaboration of more than 80 researchers across the six countries involved, to find out whether international differences in survival have changed. The study was funded by the Department of Health of England and Cancer Research UK.

It found that differences between countries in cancer survival have narrowed for some cancers but not others. Survival rates from bowel cancer rose at a similar rate across all six countries, but the UK and Denmark still lagged behind Australia, Canada, and Sweden. For example, in 2005-7 the percentage of patients surviving five years after a diagnosis of bowel cancer was 54% in the UK but 66% in Australia.

Similarly, survival from lung cancer is improving at a slower rate in the UK than in other countries. In 2005-7 30% of UK patients with lung cancer were still alive after one year, whereas the proportions were 35% in Denmark and between 39% and 44% in Australia, Canada, Norway, and Sweden. Five year survival was 9% in the UK and 11% in Denmark but 15% to 20% in the other four countries.

Breast cancer survival rates improved more in the UK and Demark than in the other countries from 1995 to 2007 but were still lower in the UK by 2007. Five year survival was 86% in the UK and 91% in Australia. The authors say that survival in the other countries may have hit a ceiling while the UK and Denmark are still catching up.

During 2005-7 survival at one year from ovarian cancer was lower in the UK (60%) and Denmark than in other countries (72% in Canada, for example). But five years after diagnosis survival was higher in the UK than in Australia and close to the level in Canada.

The lower survival rates in Denmark and the UK indicate that late diagnosis remains a problem there, the authors say. They add that the UK had a low NHS staffing level in the 1990s and that elderly people and less affluent people were affected by late diagnosis, treatment delays, and lower survival. And previous studies have shown that UK women with breast cancer were operated on less often, had axillary dissection less often, and had fewer nodes sampled than did women in other countries.

Mike Richards, England’s national director for cancer, said, “In England we have already started work on improving early diagnosis, including a new campaign starting next month to alert people to the early signs and symptoms of bowel, lung, and breast cancer and plans to give GPs more direct access to key diagnostic tests.

“Full details of our future plans will follow when the coalition government launches its new cancer strategy in the New Year.”


Cite this as: BMJ 2010;341:c7372

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