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Diagnosing cancer early is vital, new figures show

BMJ 2016; 353 doi: (Published 13 June 2016) Cite this as: BMJ 2016;353:i3277
  1. Jacqui Wise
  1. London

The survival of patients with specific types of cancer, especially lung and ovarian cancer, is substantially lower when diagnosed at a later stage than when diagnosed at an early stage, figures from the Office for National Statistics and Public Health England have shown.1

The bulletin, Cancer Survival by Stage at Diagnosis for England, includes the average one year survival rate of nine cancer types from 2012 to 2014. This is based on the number of people who die within one year of diagnosis: a figure of 100% denotes the same number of deaths as that of the general population, whereas a figure of 50% shows twice as many deaths as in the general population.

The report shows that, in general, people who have cancers diagnosed early (stage I or II) have a better one year survival than those with late (stage IV) cancer at diagnosis. Although survival is always worst if diagnosed at stage IV, differences are seen between cancer types. The one year survival rate at stage IV varies from 15% in men with lung cancer to 83% in men with prostate cancer.

Survival from breast cancer is among the highest of all cancers: 96% on average across all years when all stages are combined. This is probably due to a combination of the high number of cancers detected through screening and the increasing availability of effective treatments. If women have breast cancer diagnosed at stage I or II they have a one year survival rate very similar to that of the general population. But those whose cancer is diagnosed at stage IV have a much lower survival rate of 63%.

The overall one year survival of women with ovarian cancer is 71%. This is the second lowest rate in women, as only lung cancer is lower. Nearly half of women with ovarian cancer have it diagnosed at stages III and IV. A steadily decreasing survival rate is seen with increasing stage at diagnosis, but survival in people whose cancer is diagnosed at stage I is high, at 98%.

The report showed that survival from prostate cancer was very high, at 96% when all stages were combined. Men with prostate cancer diagnosed at stage I, II, or III have a one year survival rate that is the same as in the general population.

The one year survival with malignant melanoma is among the highest of all cancer types, as over half of melanoma cases are diagnosed at stage I. Uterine cancer also has a high one year survival rate, as nearly two in three cases are diagnosed at the earliest stage. By contrast, the overall survival from lung cancer is low (34% in men and 39% in women), partly because so many cases are diagnosed at stage IV. Survival at stage I is 81% in men and 85% in women, but fewer than one in six lung cancers is diagnosed at this stage.

Generally, women have cancer diagnosed at earlier stages than men and have better survival rates. However, bladder cancer is unusual because women have much lower survival: 62%, compared with 75% in men. The report said that this was probably due to a mix of reasons: women with bladder cancer tend to have it diagnosed at a later stage; however, women with a given stage of bladder cancer have worse survival than men with the same disease stage, which suggests differences in biology.


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