UK cancer care ‘stuck in the noughties’
New analysis shows the UK is lagging decades behind other countries when it comes to survival rates
· New analysis from Macmillan Cancer Support reveals that several UK cancer survival rates are only just reaching levels that other European countries, such as Sweden, had achieved in the early 2000s.
· On top of this, the charity warns that cancer waiting times across the UK were among the worst on record last year and people with cancer are facing significant challenges across all areas of their life including their physical and mental health, their finances and more.
· Macmillan CEO says, “cancer care is at breaking point, but this is a political choice: better is possible” and is urging the next UK government to “commit to transforming cancer care”.
Cancer survival rates in the UK are as much as 25 years behind other European countries, a leading charity is warning today.
The analysis by Macmillan Cancer Support shows that the UK’s survival rates for several common types of cancer are only just now reaching what countries such as Sweden and Norway had already achieved in the early 2000s, or even earlier in some cases[i].
The charity, which has a 113-year history of ensuring the voices of people with cancer help drive improvements, says that cancer care across the UK is making people feel “left behind” but that better is possible. Its analysis suggests if the UK’s survival rates matched the best in Europe, thousands more people who are diagnosed each year in the UK would survive their cancer for at least five years[ii].
The research shows that the latest five-year survival rates for men with colon cancer in England and women with colon cancer in Wales are still below what Sweden had already achieved by the early 2000s, with a similar picture for prostate cancer in Scotland as well as one-year survival for male colon cancer in Northern Ireland. In some cases, the gap is even larger, with survival for women with cervical cancer in England lagging 25 years behind Norway (see ‘key facts’ below)[iii].
More than 390,000 people are diagnosed with cancer each year in the UK — at least one person every 90 seconds[iv] — and ahead of the General Election the cancer charity is calling on the Government to revolutionise cancer care and turn the crisis around.
Macmillan warns that it’s not just survival rates that need addressing as a matter of urgency and cancer care throughout the whole system is at ‘breaking point’. Healthcare professionals are doing the very best they can, but they are under resourced and waiting times for cancer treatment across the UK were among the worst on record in 2023[v]. There are also huge differences in people’s experiences of cancer care — this includes research showing that people from ethnically diverse backgrounds in the UK have to wait longer to be diagnosed for several types of cancer[vi], an additional burden no-one should have to carry.
On top of this, further Macmillan data shows that hundreds of thousands of people with cancer are struggling with physical and emotional concerns as a result of their diagnosis[vii], and many are facing serious financial issues, with the charity warning that the cost-of-living crisis is now having a higher impact on people with cancer’s physical health than it has done since June 2022[viii].
For this to change the charity is urgently calling for a radical, new cross-government approach to cancer care, with a fully funded strategy to address the impact cancer has on every aspect of a person’s life.
Gemma Peters, Macmillan Cancer Support’s Chief Executive Officer, says: “Behind today’s shocking data are thousands of real people whose entire worlds have been turned upside down by cancer. Helping people with cancer live longer is important but so is the quality of their lives. They shouldn’t have to spend their days worrying about delays to their treatment or how they’ll be able to afford the petrol or bus fare they need to get to their next appointment; cancer is enough to have to deal with.
“It’s clear that cancer care is at breaking point but this is a political choice and better is possible. Cancer has led the way in changing the healthcare system for the better before, with Macmillan driving the creation of Cancer Nurse Specialists to ensure patients are treated by professionals with the right skills and expertise, and by developing groundbreaking digital assessments to ensure every person diagnosed has the best chance of receiving the care and support they need. It’s time to lead the way once again.
“Together, with politicians and partners, we can transform cancer care for a more hopeful future for people with cancer and the people who support them. We urgently need the next UK government to prioritise a long-term cross-government strategy that revolutionises cancer care and ensures everyone with cancer has access to the care they need, every step of the way.”
Rosemary Head, 83, from Langdon Hills in Essex, had to wait 8 months to be diagnosed with lung cancer due to delayed appointments. She finally had targeted treatment on the tumour in January but is yet to be told the results, so has no idea if the treatment was effective. Her follow up appointment has now been pushed back to October.
Her daughter Jackie, 58, has been caring for her while also recovering from her own lung cancer diagnosis. Jackie’s own lung cancer was dealt with quickly and she feels guilty that her mum has not had the same experience. She also lost her father to lung cancer in 2012.
Jackie said: “My mother is constantly waiting by the phone to hear what the status of her cancer is. We both regularly feel anxious. It’s not knowing and being led on by false promises of phone calls and cancelled appointments. She’s been promised a CT scan but hasn’t had one since treatment. The waiting is endless. I can see the effect it has on my mother’s wellbeing.”
She added: “The future government needs to commit to making real change. The way my mum has been treated is shocking, and no person should have to endlessly wait to know if their cancer is growing inside of them. If my mum didn’t have me, she would have given up. But I’ll never give up on speaking up for my Mum.”
Macmillan Cancer Support is inviting members of the public to contact all their local candidates, using a simple online tool, asking for a commitment to transform cancer care if elected. People can support this effort by visiting macmillan.org.uk/general-election-2024.
For anyone concerned about cancer or their care, Macmillan is at the end of the phone and online to provide vital support. Call the Macmillan Support Line on 0808 808 00 00 or visit macmillan.org.uk.
Ends
Note: Health powers are largely devolved across the UK, meaning the General Election to the UK parliament mainly affects healthcare decision-making in England. However, the General Election will also impact elements of cancer care right across the UK, whether through political dynamics with the devolved nations, welfare benefits policy or funding to devolved governments.
Notes to Editors
Key facts
· Previous international comparison studies have consistently shown the UK has among some of the worst cancer survival rates in Europe[ix], however results published from these studies do not yet include the latest available data, due to the scale of data collection and analysis needed
· To better understand the current picture in the run-up to the UK’s General Election, Macmillan has compared the most up-to-date official statistics for cancer survival across the four UK nations with the equivalent data for Sweden, Norway and Denmark. All three countries have relatively similar healthcare systems to the UK and also publish high-quality cancer survival statistics
· As well as considerably poorer survival for colon, prostate and cervical cancer, the comparison (see table below) also shows survival rates for breast cancer are lagging up to 10 years behind
· The data also shows that other countries have been able to achieve substantial improvements in survival in recent years, with five-year survival rates for men with colon cancer in Denmark increasing from less than 60% for those diagnosed in 2007–2011 to more than 70% in the most recent figures. In comparison, the five-year survival rate for men with colon cancer in England has shown little to no improvement over the same time period and may even be getting worse[x]
Survival rates comparison list[xi]
Please note: We have had to convert our data table to a list for this online version. Data is broken down below for each as follows: Cancer type, UK nation, Number of people diagnosed each year, Current survival rate, Current survival rate in comparison countries, Time period by when a comparison country had already surpassed UK nation’s current survival rate*, and Approx. number of years UK nation is lagging behind*
Colon (females)
England, 13,700 (2021), 57.6% (5-year rate for those diagnosed between 2016–2020 and followed up to 2021), Denmark — 72.7%; Norway — 71.7%; Sweden — 70.6% (all 5-year rates for those diagnosed between 2017–2021), 1997–2001 (Sweden — 60.7%): Women diagnosed with colon cancer in Sweden between 1997–2001 experienced better 5-year survival rates than women diagnosed between 2016–2020 in England, 20 years behind
Scotland, 1,500 (2021), 60.6% (5-year rate for those diagnosed between 2015–2019 and followed up to end of 2020), Denmark — 72.7%; Norway — 71.7%; Sweden — 70.6% (all 5-year rates for those diagnosed between 2017–2021), 2007–2011 (Sweden — 67.5%; and Norway — 65.7%), 10 years behind
Wales, 700 (2020), 58.9% (5-year rate for those diagnosed between 2016–2020), Denmark — 72.7%; Norway — 71.7%; Sweden — 70.6% (all 5-year rates for those diagnosed between 2017–2021), 2002–2006 (Sweden — 63.9%; and Norway — 62.8%), 15 years behind
Northern Ireland, 500 (2021), 78.3% (1-year rate for those diagnosed between 2017–2021), Denmark — 86.6%; Norway — 86.4%; Sweden — 85.6% (all 1-year), 2002–2006 (Sweden — 82.4%), 15 years behind
Colon (males)
England, 15,000, 57.6% (5-year), Denmark — 73.2%; Norway — 70.0%; Sweden — 69.4% (all 5-year), 2002–2006, (Sweden — 59.8%), 15 years behind
Scotland, 1,600, 59.8% (5-year), Denmark — 73.2%; Norway — 70.0%; Sweden — 69.4% (all 5-year), 2012–2016 (Denmark — 70.2%; Sweden — 67.1%; and Norway — 66.6%), 5 years behind
Wales, 800, 58.3% (5-year), Denmark — 73.2%; Norway — 70.0%; Sweden — 69.4% (all 5-year), 2007–2011 (Sweden — 64.7%), 10 years behind
Northern Ireland, 500, 78.8% (1-year), Denmark — 86.9%; Norway — 86.7%; Sweden — 86% (all 1-year), 2002–2006 (Sweden — 81.9%), 15 years behind
Prostate (males)
England, 43,400, 88.5% (5-year), Sweden — 95.0%; Norway — 94.8%; Denmark — 90.2% (all 5-year), 2007–2011 (Sweden — 92.3%), 10 years behind
Scotland, 4,300, 85.7% (5-year), Sweden — 95.0%; Norway — 94.8%; Denmark — 90.2% (all 5-year), 2002–2006 (Sweden — 89.3%), 15 years behind
Wales, 2,300, 96.7% (5-year), Sweden — 95.0%; Norway — 94.8%; Denmark — 90.2% (all 5-year), n/a**, n/a**
Northern Ireland, 1,400, 97.3% (1-year), Norway — 99.3%; Sweden — 99.3%; Denmark — 98.6% (all 1-year), 2007–2011 (Sweden — 98.6%; and Norway — 98.4%), 10 years behind
Breast (females)
England, 49,400, 85.9% (5-year), Sweden — 92.5%; Norway — 90.8%; Denmark — 90.3% (all 5-year), 2007–2011 (Sweden — 90.1% and Denmark — 87.4%), 10 years behind
Scotland, 5,100, 86.2% (5-year), Sweden — 92.5%; Norway — 90.8%; Denmark — 90.3% (all 5-year), 2007–2011 (Sweden — 90.1%), 10 years behind
Wales, 2,300, 90.3% (5-year), Sweden — 92.5%; Norway — 90.8%; Denmark — 90.3% (all 5-year), n/a**, n/a**
Northern Ireland, 1,600, 96.0% (1-year), Sweden — 98.4%; Norway — 97.6%; Denmark — 97.5% (all 1-year), 2007–2011 (Sweden — 97.8%), 10 years behind
Cervical (females)
England, 2,800, 61.4% (5-year), Denmark — 76.6% Norway — 76.4% Sweden — 74.7% (all 5-year), 1992–1996 (Norway — 66.2%), 25 years behind
Scotland, 300, 65.1% (5-year), Denmark — 76.6% Norway — 76.4% Sweden — 74.7% (all 5-year), n/a**, n/a**
Wales, 100, ***, Denmark — 76.6% Norway — 76.4% Sweden — 74.7% (all 5-year), n/a***, n/a***
Northern Ireland, 100, 87.1% (1-year), Norway — 91%: Denmark — 90.4%: Sweden — 90.3% (all 1-year), n/a**, n/a**
Rectal (males)
England, 8,300, 59.5% (5-year), Denmark — 72.3%, Norway — 72.3%, Sweden — 69.3% (all 5-year), 2007–2011 (Norway — 67.1%; Sweden — 64%; Denmark — 63.1%), 10 years behind
Scotland, 800, 59.1% (5-year), Denmark — 72.3%, Norway — 72.3%, Sweden — 69.3% (all 5-year), 2007–2011 (Norway — 67.1%), 10 years behind
Wales, 400, 58.2% (5-year), Denmark — 72.3%, Norway — 72.3%, Sweden — 69.3% (all 5-year), 2007–2011 (Norway — 67.1%; Sweden — 64%; Denmark — 63.1%), 10 years behind
Northern Ireland, 300, 85.3% (1-year), Sweden — 89.1%; Norway — 89.7% ; Denmark — 90% (all 1-year), 2012–2016 (Norway — 89.6%; Denmark — 88.7%), 5 years behind
Rectal (females)
England, 4,600, 59.9% (5-year), Sweden — 71.5% Denmark — 75.3% Norway — 74.3% (all 5-year), 2002–2006 (Norway — 66.7%; Sweden — 63.9%), 15 years behind
Scotland, 500, 59.4% (5-year), Sweden — 71.5% Denmark — 75.3% Norway — 74.3% (all 5-year), 2007–2011 (Norway — 69.4%), 10 years behind
Wales, 200, 60.7% (5-year), Sweden — 71.5% Denmark — 75.3% Norway — 74.3% (all 5-year), 2002–2006 (Norway — 66.7%), 15 years behind
Northern Ireland, 100, 84.1% (1-year), Sweden — 89.2%; Norway — 90.4%; Denmark — 90.0% (all 1-year), 2012–2016 (Norway — 89.8%; Denmark — 89.2%; Sweden — 89.2%), 5 years behind
*‘Lagging behind’ figure is an estimate of the number of years that have passed since the comparison country attained a survival rate exceeding the current survival rate of the UK nation. Five-year time periods shown refer to time of cancer diagnosis, e.g. ‘1997–2001’ refers to people diagnosed with cancer between 1997 and 2001. Non-overlapping 95% confidence intervals are considered to have a statistically significant difference. Due to limitations on the level of precision that is possible with this kind of comparison we have rounded the estimate to the nearest 5 years.
**Difference in survival rates is not statistically significant
***Wales 5-year net survival rate for cervical cancer is not age-standardised so not directly comparable here
References
[i] See ‘Key facts’ table above for detail. Based on a combination of analysis from the following sources, using age-standardised net and relative survival. We consider the 5-year survival rates of two nations to have a statistically significant difference if their 95% confidence intervals do not overlap.
· NHS England. Cancer Survival in England, cancers diagnosed 2016 to 2020, followed up to 2021. February 2023 (accessed May 2024)
· Public Health Scotland. Cancer survival statistics — People diagnosed with cancer during 2015 to 2019. July 2022 (accessed May 2024)
· Public Health Wales. Cancer survival in Wales, 2002–2020. November 2023 (accessed May 2024). Latest five-year time period for which net survival rates are available is for people diagnosed between 2016 and 2020
· Northern Ireland Cancer Registry. Official statistics. Accessed May 2024 (please note: at time of publication, comparable five-year survival rates were not publicly available; the latest time period for which one-year net survival rates are available is for people diagnosed between 2017 and 2021)
· Association of the Nordic Cancer Registries (NORDCAN). Survival — trends. Accessed June 2024. Latest time period for which five-year relative survival rates are available is for people diagnosed between 2017 and 2021
[ii] Taking the figures and sources given in reference 1 as an example: The data for colon cancer for women in England is based on 55,429 women diagnosed between 2016 and 2020. With a net/relative 5-year survival rate of 57.6% we would expect around 23,500 of these women to have died from cancer within 5 years of diagnosis. If the 5-year survival rate was the same as Sweden’s during this time, at 70.6%, we would expect the number to have died from cancer to be around 16,300, suggesting around 8,000 fewer women would have died from colon cancer during this 5-year period — around 1,600 per year. This suggests that if survival rates for all cancer types in the UK matched the best in Europe, thousands more people diagnosed with cancer each year in the UK would survive at least five years from diagnosis
[iii] As per ref 1
[iv] Based on aggregated UK-wide figures for 2020, the latest year for which cancer incidence data is available for all countries in the UK. Figures include all malignant neoplasms excluding non-melanoma skin cancer (NMSC) (ICD-10 codes C00–97 excl. C44. Scotland does not use C97):
- NHS England — National Cancer Registration and Analysis Service
- Public Health Scotland
- Cancer Reporting Tool — Official Statistics — Public Health Wales
- Northern Ireland Cancer Registry Queen’s University Belfast
[v] Based on a combination of analysis from the following sources:
· NHS England https://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/ and https://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/#cwt-statistics-up-to-september-2023
· Public Health Scotland. Cancer waiting times — 1 October to 31 December 2023
· Suspected Cancer Pathways data from StatsWales
· Northern Ireland Department of Health. Cancer waiting times
[vi] One study of seven types of cancer shows on average Asian people with cancer in the UK wait 16% longer to be diagnosed than white people, while Black people wait 10% longer. Source: Martins T, Abel G, Ukoumunne OC et al. Assessing ethnic inequalities in diagnostic interval of common cancers: A population-based UK cohort study. Cancers 2022; 14: 3085. https://doi.org/10.3390/cancers14133085
[vii] Hundreds of thousands of people with cancer across the UK have serious concerns related to their diagnosis, including their mental health (23%), exhaustion or fatigue (26%), bowel or bladder issues (26%), or sex, libido or fertility (23%). Source: Macmillan Cancer Support/YouGov survey of 2,099 adults in the UK who have had a cancer diagnosis. Fieldwork was undertaken between 2nd January and 22nd January 2024. The survey was carried out online. The figures have been weighted and are representative of people living with cancer in the UK (aged 18+). Survey question was as follows: Have you had any concerns about any of the following issues in the last few weeks, which were caused or have been made worse by your experience of cancer? Please mark on the scale of 1–5, where 1 is ‘not an area of concern’ and 5 is ‘an area of great concern’. 23% of respondents selected 4–5 for either ‘sadness or depression’, or ‘worry, fear or anxiety’; 26% of respondents selected 4–5 for ‘Feeling exhausted or fatigued’, 26% selected 4–5 for either ‘Constipation/ diarrhoea/ flatulence/ bowel urgency’ or ‘Bladder incontinence/ urgency’, and 23% selected 4–5 for either ‘Loss of libido/ sexual needs’ or ‘Sex or fertility’. ‘Hundreds of thousands’ estimated by applying these figures to the 3 million people living with cancer in the UK (26% = 780,000 people; 23% = 690,000 people). 3 million figure derived from: Macmillan Cancer Support. Cancer prevalence. Accessed May 2024
[viii] Macmillan Cancer Support/YouGov survey of 2,099 adults in the UK who have had a cancer diagnosis. Fieldwork was undertaken between 2nd January and 22nd January 2024. The survey was carried out online. The figures have been weighted and are representative of people living with cancer in the UK (aged 18+). Relevant survey questions were as follows: “Thinking about now compared to 8 to 10 weeks ago (i.e. since early November 2023), overall have any of your basic living costs increased or decreased? Please think about the costs that you have to pay as part of day-to-day living, including food, bills, housing rent, mortgage(s) etc.” In total, 72% of respondents said their basic living costs had increased. This group were then asked: “In which, if any, of the following ways have increased living costs affected you and your personal life?“ The proportion of those affected by increased costs who said their physical health had been affected (15%) was the highest since Macmillan first started tracking this question in June 2022
[ix] International studies include EUROCARE, CONCORD and the International Cancer Benchmarking Partnership studies. Example published results include the following:
· De Angelis R, Sant M, Coleman MP, et al; EUROCARE-5 Working Group. Cancer survival in Europe 1999–2007 by country and age: results of EUROCARE — 5-a population-based study. Lancet Oncol 2014; 15: 23–34. doi: 10.1016/S1470–2045(13)70546–1
· Allemani C, Matsuda T, Di Carlo V, et al; CONCORD Working Group. Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet 2018; 391: 1023–1075. doi: 10.1016/S0140–6736(17)33326–3
· Arnold M, Rutherford MJ, Bardot A et al. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol 2019; 20: 1493–1505. doi: 10.1016/S1470–2045(19)30456–5
[x] As per ref 1. The age-standardised relative five-year survival rate for men with colon cancer in Denmark has increased from 59.6% for those diagnosed between 2007 and 2011 to 73.2% for those diagnosed between 2017 and 2021. Sweden and Norway have also seen survival rates improve by around 5 and 8 percentage points respectively over this time (from 64.7% to 69.4% for Sweden and from 61.7% to 70% for Norway). In contrast, the rate for men with colon cancer in England was 56.1% for those diagnosed between 2007 and 2011 and is currently 55.7% for those diagnosed between 2016 and 2020, with an official trend estimate of -0.2%
[xi] As per ref 1. Figures for ‘numbers of people diagnosed each year’ taken from the following sources:
· NHS England. Cancer Registration Statistics, England, 2021 — Full release. May 2024 (accessed June 2024)
· Public Health Scotland. Cancer incidence in Scotland to December 2021. March 2023 (accessed June 2024)
· Public Health Wales. Cancer incidence in Wales. September 2023 (accessed June 2024)
· Northern Ireland Cancer Registry. Official statistics. Accessed June 2024
