London School of Hygiene & Tropical Medicine

Comment on the Office for National Statistics bulletin which presents an index of survival for all cancers combined at one year after diagnosis for the 211 Clinical Commissioning Groups (CCGs) in England (adults diagnosed 1997-2012 and followed up to 2013).

Dr Bernard Rachet, Reader in Cancer Epidemiology at the London School of Hygiene & Tropical Medicine, who produced the bulletin in partnership with ONS, said:

"Overall 69% of people in England diagnosed with cancer will survive from their disease for at least one year, compared to 60% in 1997.* Maximum differences in the one-year survival index between Clinical Commissioning Groups (CCGs) remain wide, though narrowed slightly with time: from around 13% in 1997 to 10% in 2012. Although there are still geographic inequalities in survival between the north and the south of England (the south continues to perform better), the good news is that we can see that this gap is getting smaller.

"Less positively, we continue to see that there is a nationwide 'age gap' in survival. On average around the country, an elderly patient has 18% lower survival across all cancers compared with middle-aged patients. This is after we had adjusted for the fact that older people have higher death rates from other diseases than younger people. It should not be the case that elderly people are doing worse for all cancers. Other research has suggested that this problem is particularly marked in the UK. In other countries, the age gap in cancer survival has become much narrower over the last 15-20 years.

"As well as providing an important national overview, the figures are intended to be a useful tool for CCGs, to help them review their performance and identify potential for improvement in the diagnosis, referral and treatment of cancer patients."

* 69.3% net survival index, all cancers combined, one year after diagnosis during 2012, an increase from 59.7% net survival index, all cancers combined, one year after diagnosis in 1997.

Comment on the Office for National Statistics bulletin, which presents one-year and five-year age-standardised net survival estimates for the 25 NHS England Area Teams, for patients who were diagnosed with a cancer of the oesophagus, stomach, colon, lung, breast (women) or cervix during 1997-2012 and followed up to 31 December 2013.

Dr Bernard Rachet, said:

"On a national level we observed an improvement in one and five-year net survival for all six cancers covered in these estimates (oesophagus, stomach, colon, lung, breast (women), cervix).

"The greatest overall improvement in one-year survival was for oesophageal cancer in men. However, in women, oesophageal cancer also showed the greatest geographic disparity in survival- ranging by 14.6% between NHS England Area Team.

"The geographical differences narrowed for some cancers (colon (both sexes), oesophagus (men), breast (women) and cervix). In general, we see that it is the cancers with poorer overall prognosis (oesophagus, stomach and lung) that have the widest range in one-year survival according to NHS Area Team."