Should we expect more on cancer?

Lung cancer The UK performs poorly on lung cancer survival compared with other developed countries

It seems like a churlish question to be asking after such a remarkable improvement.

But despite a doubling in 10-year cancer survival rates since the early 1970s, there is a nagging sense that the picture set out by Cancer Research UK could be even better.

Granted, the last 40 years have been a story of almost continuous improvement - so much so that cancer, in many cases, has effectively gone from being a death sentence to a chronic condition.

And yet it is understandable that we should want more.

International comparisons still show the NHS lagging behind other western nations. The Eurocare Five study published in the Lancet in December last year revealed the UK was doing significant worse in terms of colon, ovary, kidney, stomach and lung cancers in particular.

It is a point picked up by Prof Michel Coleman, who crunched the figures for Cancer Research UK.

He highlights the fact the UK has a particularly poor record when it comes to early diagnosis. This is essential, as the earlier the disease is found the easier it is to treat.

What is the cause of this? Well, there is clearly an issue with improving public awareness about the symptoms. This can be seen from the success of the 2012 government campaign urging people with persistent coughs to go to their GPs, which saw lung cancer diagnosis rates jump by nearly 10%.

But there is also a problem with GPs recognising cancer. A quarter of cancers are still diagnosed after an visit to A&E.

Woman coughing A 2012 lung cancer campaign about persistent coughs boosted diagnosis

To be fair, the average GP will only see six to eight new cancers each year and for the most rare types, such as brain cancer, it is a once-a-decade situation.

Prof Coleman says, therefore, it would "not be right to blame GPs", but he acknowledges it raises questions about the way cancer diagnosis is handled by the health service.

In the NHS, GPs act as gatekeepers to the system in a way that doesn't happen in many other countries.

This is one of the reasons the NHS is considered one of the most efficient in the world, but in terms of speedy cancer diagnosis it could be a barrier.

However, research has also shows that it is not all down to early diagnosis. Even in areas where the NHS does well in terms of detection (breast and colon cancers to name two) survival rates are still not up there with the best.

This suggests there is an issue with getting access to effective treatment. While much of the focus is often on drugs, surgery is by far a more important factor when it comes to cancer treatment.

There is nothing to suggest UK-trained doctors are any worse than those from other countries (in fact there is plenty showing they are among the best).

But the NHS has been found to be lacking when it comes to vital equipment, such as MRI scanners. This can mean there are problems with identifying how far the cancer has spread and, as a result, how effective the treatment can be.

Cancer Research UK wants to see 10-year survival rates continue increasing. If this is to happen, tackling these issues will be just as important as investing in research to develop new technologies and treatments.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 141.

    Sort of progress. But cancers return - even a decade later. Or new ones. And some annual check-up routines are minimal "New lumps, taking the drugs still, feeling OK?" That's it

    Few annual reviews include an XRay, an MRI scans or blood markers to show the difference between this year and last. Faulty process design. And then back it comes, undetected until too late. Result - tragedy

  • rate this

    Comment number 140.

    More info needed re European systems. Some allow direct access to consultants, others use GP gatekeepers as here. Many offer care free at point of use. Unless we know what's going right elsewhere we're not going to discover what's going wrong here. But as usual we Brits think we have nothing to learn from Johnny Foreigner.

  • rate this

    Comment number 139.

    Should we expect more?

    Not for as long as politicians are involved.

  • rate this

    Comment number 138.

    People are at the crux of the medical field - there will always be human error and, whilst tragic for those it effects, it should not be used as a stick to beat the NHS with. Mistakes occur all the time in every facet of life - most do not have such serious consequences.

    Longer working hours, bigger patient load, less funding - all things guaranteed to increase human error in the NHS.

  • rate this

    Comment number 137.

    Why are people arguing the toss over cancer? We should all be working together to beat it


Comments 5 of 141


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