Despite the fact national cancer strategies have been in place since 2000, there is “little evidence” to suggest that short-term survival rates in England have improved. That’s one of the key messages to come out of new research by the London School of Hygiene & Tropical Medicine (LSHTM).
The NHS Cancer Plan, which was implemented in 2000, is designed to improve cancer survival rates in the UK so they are in line with the rest of Europe, as well as reducing inequalities in cancer survival.
However, the researchers found that despite this being the focus of the national strategy, there has been little to no direct impact when it comes to increasing survival rates and reducing inequalities.
For their population-based cohort study, which was published in the BMJ, researchers from LSHTM analysed 3.5 million individuals aged 15 to 99 who were diagnosed with one of the 24 most common cancers between 1996 and 2013.
To establish how effective the NHS Cancer Plan has been, patients diagnosed between 1996 and 2000 (before its introduction) were analysed separately to those diagnosed post-2000. In fact, to allow for the plan to take effect, patients diagnosed post-2000 were separated into two groups: 2001 to 2005 and 2006-2013.
For each type of cancer, the chances of survival at one year after diagnosis were estimated separately for men and women in five levels of socio-economic deprivation. These varied from the most affluent to the most deprived, and in each of the three calendar periods outlined above.
The reason the researchers focussed on one-year survival rates is because most of the cancer survival inequalities in England arise shortly after diagnosis.
They found that while one-year survival rates improved for 16 of the 20 cancers examined in men and 20 of the 21 cancers examined in women, they were consistently lower for patients in deprived areas, with the deprivation gap remaining unchanged for 13 cancers in men and 17 in women.
The largest improvements in terms of survival were seen in cancers for which survival was poor or intermediate in the 1990s, such as cancer of the lung in women, cancers of the oesophagus and liver in men, and kidney, myeloma and mesothelioma in both sexes.
Survival rates for men diagnosed with cancer of the testis or larynx or Hodgkin lymphoma was already high in the 1990s and by 2013, there had been little further increase, further suggesting the NHS Cancer Plan had had little effect.
The “deprivation gap” in survival between the most affluent and most deprived groups of patients remained unchanged for most cancers.
The researchers found a clear and persistent relationship between lower survival rates and deprived patients. However, it did narrow slightly for some cancers, such as skin melanoma in men and cervical cancer in women.
Aimilia Exarchakou, lead author from the Cancer Survival Group at LSHTM, said: “More attention needs be paid to healthcare system factors, such as the levels of staffing, equipment and funding,” she argued. This might be beneficial in improving cancer outcomes and reducing socioeconomic inequalities.”
It’s quite eye-opening that the “deprivation gap” in survival between the most affluent and most deprived groups of patients remained unchanged for most cancers.
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