UK ranks last of six countries in lung cancer survival

BMJ 2013; 346 doi: (Published 12 February 2013) Cite this as: BMJ 2013;346:f935
  1. Jacqui Wise
  1. 1London

The United Kingdom lags behind other wealthy countries in terms of one year survival after diagnosis of lung cancer, a large study shows. The researchers said that this may be partly because of late diagnosis but also because UK patients with lung cancer may not be getting the best available treatment, whatever the stage of their disease at diagnosis.

The research, published in Thorax, shows that one year survival in patients with non-small cell lung cancer ranged from 30% in the UK to 46% in Sweden.1 Survival was also high (42%) in Australia and Canada but was lower in Norway, at 39%, and Denmark, at 34%.

The research was carried out by the International Cancer Benchmarking Partnership and included 57 352 patients whose lung cancer was diagnosed in 2004-07 in six countries. Patients’ information was taken from routinely collected, population based data.

The differences in survival were partly explained by differences in stage of cancer at diagnosis. In Denmark and the UK only one in seven cases of non-small cell lung cancer were diagnosed at stage I, whereas the proportion was one in five in Sweden and Canada. One year survival among patients with the earliest stage disease was 72.5% in the UK but 88% in Sweden.

The UK also had lower survival overall among patients with small cell lung cancer and at each stage of diagnosis than the other countries.

The lead author, Sarah Walters, from the Cancer Survival Group at the London School of Hygiene and Tropical Medicine, said, “We’ve shown that wide international inequalities in lung cancer survival occur, even between patients who were diagnosed at the same stage of disease. This indicates that the quality of stage specific treatment may differ even between these six wealthy countries with universal access to healthcare.”

The UK also had the highest proportion of patients whose stage at diagnosis was missing. Walters said, “It is clearly important to include stage at diagnosis in future international studies of cancer survival. Such comparisons would be easier if stage data were systematically recorded in the medical records and coded in the cancer registries using international standard classifications.”

Sara Hiom, director of early diagnosis at Cancer Research UK, said, “This research should remind us that while great progress is being made in the diagnosis and treatment of cancer in the UK, we mustn’t be complacent. Around 35 000 people still die from lung cancer each year in the UK, and that’s far too many. We would like to see ongoing improvements in data collection and the use of uniform systems for data on stage, in order to improve the accuracy of global comparisons.”


Cite this as: BMJ 2013;346:f935


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