Cancer care in the UK has come under fire again following the publication of two new reports highlighting huge variation in one-year survival rates across the country and poor early detection of the disease.

A report by the government’s cancer czar, Professor Mike Richards, has unveiled extreme differences in one-year survival figures for cancer depending on where patients live, reigniting concerns over the current postcode lottery of care in the current healthcare system and again highlighting the UK’s poor standing compared with its European peers in terms of cancer care.

For example, just 15.4% of lung cancer patients in Herefordshire were alive 12 months after diagnosis compared to 43.7% in the borough of Kensington and Chelsea, which, incidentally, was also the only Primary Care Trust in the UK to reach the internationally recognised ‘good practice’ level of 37% or higher for this type of cancer.

Findings of the report also showed that nearly all trusts in the country fell short of the best survival rates elsewhere in Europe which, according to Cancer Research UK, supports the view that “patients in the UK are, on average, being diagnosed at a much later stage, when specialist cancer treatments are least effective”.

“These shocking statistics confirm that the cancer postcode lottery remains a real problem,” commented CR UK’s chief executive Harpal Kumar. “Patients are undoubtedly not being diagnosed early enough in large parts of the country, nor are they getting equal access to the best treatments, such as surgery for lung cancer,” he said, and added there is “no excuse” for such big differences.

On the plus side, the figures, which are published in Prof Richard’s second annual report for the Cancer Reform Strategy - a £370-million package of measures suggested in December 2007 to drive improvements to cancer care over a five-year period - also show that overall mortality rates in the country are continuing to decline.

According to Prof Richards “excellent progress has been made in national implementation of the Cancer Reform Strategy over the past year,” noting in particular a fall in cancer death rates of almost 20% since 1997 and “considerable improvements in the survival rates for breast, colon, rectum and prostate cancer”. The challenge now, he stressed, is to keep up this momentum and tackle the stark local variations in outcomes.

Early detection must improve
Timely cancer diagnosis remains a key problem in the UK, where patients are diagnosed later and with more advanced disease than elsewhere in Europe. Earlier detection of the disease could save thousands of lives, Richards said, and suggested that improving GP access to diagnostic tests as well as raising public awareness of potential symptoms could help to make a difference.

A report published by the All Party Parliamentary Group on Cancer this week has also called for radical reform of NHS cancer targets which, it claims, could save the lives of thousands of people who are dying from the disease unnecessarily very year.

The report has put forward eight ‘priorities for action’ designed to close the gap in survival rates and boost cancer outcomes, and its key recommendations include: a new one-year cancer survival rate target to cover all ages, including those over 75; a separate national body - the National Specialised Commissioning Group - to commission drugs for patients with very rare cancers bypassing the cost watchdog the National Institute for Health and Clinical Excellence; and improved data collection to help primary care trusts plan effectively for their local populations.