Cancer survival: impact on cancer control policy in England

A European study in 2003 published data showing that five-year cancer survival rates in the UK were below the European average for most cancers.

The core target in the government’s national strategy for cancer in England is to “save 5,000 lives” a year by 2015, a target taken from the School’s research which showed that 10,000 deaths a year could be avoided if the UK’s cancer rates were as high as the best in Europe.

The School’s Cancer Survival Group, led by Michael Coleman, professor of epidemiology and vital statistics at the School, and Bernard Rachet, clinical lecturer, was established in 2005 to identify, quantify and explain inequalities in cancer survival and inform health policy.

The group’s early work included evaluation of the effectiveness of England’s NHS Cancer Plan (2000) in improving one-year survival rates. Wales did not have a cancer plan and the group showed that survival increased more quickly in England than in Wales in about half the cancers examined.

In 2008 the group developed a method of working out how many lives would be saved each year, if the five-year cancer survival rate in England was as good as the best in Europe. This research underpinned the UK national strategy on cancer and led to the National Awareness and Early Diagnosis Initiative in 2008.

The government has focused its entire cancer strategy on halving the gap in avoidable premature cancer deaths, identified in the School’s research. The Department of Health commissioned the group to design and execute survival comparisons for the International Cancer Benchmarking Partnership, which aims to improve cancer survival outcomes. The School’s research also fed into the government’s strategy for reforming health and care services, Improving Outcomes: a strategy for Cancer.

The Cancer Survival Group rapidly produced evidence to refute a British Medical Journal editorial in 2010 by two eminent cancer specialists, which dismissed “unreliable” international comparisons of survival rates. The editorial threatened to undermine confidence in the government’s cancer study but the School’s critique provided evidence of the robustness of the comparisons.

A later study commissioned by the Department of Health showed that survival rates up to 2007 had improved faster for breast cancer, but not for cancers of the bowel, lung or ovary. Subsequent studies blamed late diagnosis and lower stage-specific survival for the poor rates.

The group has produced the UK’s national statistics on cancer survival since 1999, working with the Office for National Statistics since 2008. In January 2013, the School developed interim metrics to evaluate progress towards the national target of saving 5,000 lives a year.