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Cancer survival data emphasise importance of early diagnosis

BMJ 2019; 364 doi: (Published 25 January 2019) Cite this as: BMJ 2019;364:l408

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Re: Cancer survival data emphasise importance of early diagnosis

The Office for National Statistics, UK, cited that the survival rate for 1 and 5 years of patients with cancer is higher if detected at an early stage, emphasising the importance of early diagnosis. In India, the Cancer Survival Rate for 1 and 5 years is lower than that in Europe or North America.

Prostate cancer has no linkage of survival rates with the stage of detection. It has 100% one year survival if detected at stage 1, 2 and 3, which falls to 87.6% for stage 4. Whereas 5 year survival for stage 1,2,3 is nearly 100%, it is 47.7% for stage 4. In India, 5 year survival for prostate cancer is 64%. In India, the incidence rate is low as compared to other developed countries due to a vegetarian diet. Same goes for Hodgkin Lymphoma where 1 year survival at stage 4 is 86.7%. In India, according to research done in 2018, the 5 year overall survival is 70%, much lesser than the developed countries. Colorectal Cancer shows the vast diversity from 97.7% to 43.9% at stage 1 and 4 respectively. Lung Cancer too has same pattern, with one year survival at 87.3% for stage 1 and 18.7% for stage 4. In India, 5 year survival for colon cancer is 37% with the decrease in the survival rate for rectal cancer in India. 5 year survival rate for lung cancer is 10% in India. Unusual Pattern for Liver Cancer is such that 1 year survival at stage 2 is 69.1% and at stage 3 it is 39.3%. Only 4% of patients with liver cancer survive for 5 years in India compared to 10-20% elsewhere. This research thus shows mixed results and does not entirely focus on awareness and early detection.

Prostate and Breast Cancer have the highest rate of early detection while Melanoma, Prostate and Breast Cancer have highest survival rate in England. In India, Breast Cancer, Oral cancer and Uterine Cervix are detected at an early stage.

Sarah Caul said the survival rates have increased from the estimates of 2006 to 2010. As all the cancers do not have the staging system or numbers are so small, survival due to the stage is not available for all common cancers. Ruth Thorlby, appreciating the improved cancer survival in England, said that it was possible because of sustained efforts and investment over the two decades. But still, there is long run to go as today also many cancers are diagnosed at an advanced stage--for example almost half of lung cancers.

Dr. Smita Asthana, Scientist E, ICMR-NICPR, Noida
Dr. Parul, Intern, ICMR-NICPR, Noida
Dr. Satyanarayana Labani, Scientist G, ICMR-NICPR, Noida

Competing interests: No competing interests

05 February 2019
Smita Asthana
scientist E
Parul, Satyanarayana Labani