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Comparative Study
. 2015 Sep 1;113(5):848-60.
doi: 10.1038/bjc.2015.265. Epub 2015 Aug 4.

Is England closing the international gap in cancer survival?

Sarah Walters  1 , Sara Benitez-Majano  1 , Patrick Muller  1 , Michel P Coleman  1 , Claudia Allemani  1 , John Butler  1   2 , Mick Peake  3 , Marianne Grønlie Guren  4   5 , Bengt Glimelius  6 , Stefan Bergström  7 , Lars Påhlman  8 , Bernard Rachet  1
Affiliations
Comparative Study

Is England closing the international gap in cancer survival?

Sarah Walters et al. Br J Cancer. .

Abstract

Background: We provide an up-to-date international comparison of cancer survival, assessing whether England is 'closing the gap' compared with other high-income countries.

Methods: Net survival was estimated using national, population-based, cancer registrations for 1.9 million patients diagnosed with a cancer of the stomach, colon, rectum, lung, breast (women) or ovary in England during 1995-2012. Trends during 1995-2009 were compared with estimates for Australia, Canada, Denmark, Norway and Sweden. Clinicians were interviewed to help interpret trends.

Results: Survival from all cancers remained lower in England than in Australia, Canada, Norway and Sweden by 2005-2009. For some cancers, survival improved more in England than in other countries between 1995-1999 and 2005-2009; for example, 1-year survival from stomach, rectal, lung, breast and ovarian cancers improved more than in Australia and Canada. There has been acceleration in lung cancer survival improvement in England recently, with average annual improvement in 1-year survival rising to 2% during 2010-2012. Survival improved more in Denmark than in England for rectal and lung cancers between 1995-1999 and 2005-2009.

Conclusions: Survival has increased in England since the mid-1990s in the context of strategic reform in cancer control, however, survival remains lower than in comparable developed countries and continued investment is needed to close the international survival gap.

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Figures

Figure 1
Figure 1
Data sources and periods of diagnosis. The data in our study originated either from the CONCORD-2 study or from the Office for National Statistics. Patients from England were grouped based on their date of diagnosis both by calendar periods of the CONCORD-2 study (for comparability with the other countries) and by year (to allow analysis of yearly changes).
Figure 2
Figure 2
Trends in 1- and 5-year net survival in Australia (A), Canada (C), Denmark (D), England (E), Norway (N) and Sweden (S) by period of diagnosis. Estimates of net survival are presented for the calendar periods of diagnosis 1995–1999, 2000–2004 and 2005–2009. Simple linear regression lines are presented for each combination of country and cancer using data from these three periods, to indicate the average change in survival. An estimate of net survival for England only is also presented for the calendar period of diagnosis 2010–2012.
Figure 3
Figure 3
Trends in 1- and 5-year net survival in England by year of diagnosis. Unfilled and filled markers represent estimates of 1- and 5-year net survival, respectively. The average arithmetic improvement in survival between years is shown for the calendar periods 1995–1999, 2000–2004, 2005–2009 and 2010–2013 above the trends.
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