Health: Britain Lags Behind in World Cancer Survival, Says Study

Cancer survival rates in the UK lag behind much of the rest of the world, according to the first-ever global study, published today, which puts the United States, Canada, Australia, Japan and France at the top of the league.

The study, led by the leading cancer epidemiologist Professor Michel Coleman, from the London School of Hygiene and Tropical Medicine, compared data from 31 countries, including the UK's four nations. Comparative information exists on death rates and on the numbers of people getting cancer, but not on those who survive for at least five years - largely a measure of the success of the care patients get.

The results see the US take pole position in breast and prostate cancer survival and second place in colorectal cancer survival for both men and women. On the numbers alone Cuba beats the US, with the best survival rates in all but prostate cancer. But the researchers say the absence of valid data on a quarter of the Cuban deaths means its success is probably over-estimated. Bottom of the league by a long way is Algeria.

England comes 22nd in breast cancer survival rates, 19th in prostate cancer survival and 21st and 22nd respectively in women's and men's colorectal cancer survival.

Northern Ireland and Scotland do slightly better and Wales slightly worse. The Trent region had the lowest survival rate in England for all the cancers.

More than 100 scientists were involved in the study, which collected data on 1.9 million adults who were diagnosed with a first invasive cancer between 1990 and 1994 and were followed up to 1999 to establish whether or not they had survived for five years.

The UK's low position in the league table will reignite controversy over government health policy. The government says the UK is now doing much better, because of the substantial investment in health in recent years. But the most recent European data, from the Eurocare 4 study of patients diagnosed in 1995-99 and followed up to the end of 2003, showed that the UK had improved, but was still below the European mean survival rate for most common cancers.

According to Coleman, the most interesting finding from the study is how, in some countries patients appear to get good care wherever they are - which is not the case in the US, despite its apparently good performance.

"The geographical variations in Canada and Australia are very limited," he said. "The Australian and Canadian picture shows pretty uniform access and high quality care."

The survival differences between the UK and Australia have been noted before, the scientists say in their paper. "Elderly women in England had especially poor survival. More effective treatment in Australia is a plausible explanation."

The study shows substantial variations in survival across the 31 countries. It concludes that the main issue is probably differences in access to diagnostic and treatment services: how rich a country is and how much it spends on cancer care.