Despite the improvements made in improving cancer services since 2010, survival rates in England are about 10% lower than the European average, says the National Audit Office.
Overall outcomes for cancer patients have continued to improve since the NAO last reported on England's cancer services, in 2010, it says. For example, the proportion of people surviving for one year and five years after diagnosis has increased to 69% (for those diagnosed in 2012) and 49% (for those diagnosed in 2013), respectively.
And generally, better information is becoming available to support improvements in cancer care; for example, the proportion of newly-diagnosed cancers with “staging data” (a record of how advanced a person’s cancer is at diagnosis) increased from 33% of cases in 2007 to 62% in 2012.
However, outcomes for cancer patients and access to services vary significantly across the country. They are generally poorer for older patients in particular, while those from more deprived socio-economic groups are also more likely to experience worse outcomes than those from less deprived groups.
There would be nearly 20,000 fewer deaths from cancer each year if mortality rates for all socio-economic groups were the same as for the least deprived, says the NAO.
Moreover, the report shows that the number of NHS trusts and foundation trusts breaching the government’s 62-day cancer referral standard has doubled in one year. Targets for England state that 85% of patients should be treated within 62 days of being referred by their GP.
Juliet Bouverie, director of services and influencing at Macmillan Cancer Support, said the report shows there have been some considerable improvements in cancer survival rates over the past five years in England, thanks to better treatments, earlier diagnosis and greater awareness.
Nevertheless, “England continues to have some of the worst cancer survival rates in Europe and the gap gets far wider when you compare the older age groups. If we want to get serious about improving our survival rates in England, then we are going to have to address some of the inequalities this report highlights. This means giving older people cancer treatment and care based on their needs, not on their age,” she said.
Sarah Woolnough, executive director of policy at Cancer Research UK, also pointed to the report’s finding that one in five cases of cancer were diagnosed through emergency routes between July and December 2012.
We must do better for patients, and improving early diagnosis and access to the best treatments has to be a priority, she said.
And Stephen Whitehead, CEO of the Association of the British Pharmaceutical Industry (ABPI), said that while the Cancer Drugs Fund was introduced as a temporary measure to enable the same level of access to medicines as is routinely available across the European Union (EU), “we can see from patient experience that it has proved nothing more than a sticking plaster, having little effect at redressing the balance.”
“Now is the time to find a long-term, sustainable solution for evaluating the cost-effectiveness and efficacy of all medicines, and we believe that the only solution remains the urgent reform of NICE [the National Institute for Health and Care Excellence],” he said.