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Posted: December 25, 2010 12:30 a.m.

Cancer survival rates vary by country

A recent article in England’s medical journal "The Lancet" reported that survival rates for four major cancers are lower in the United Kingdom (excluding Scotland), than in Australia, Canada, Sweden and Norway, and equivalent with those of Denmark. The study was from the International Cancer Benchmarking Partnership. Differences in diagnoses and treatment in these countries are considered to account for this finding.

The study authors declared that cancer survival rates are a key measure of the effectiveness of healthcare systems in a nation or region. Addressing differences in survival rates between regions is one way to stimulate change to raise standards and improve quality of care.

This study is the first in a series of cancer studies by ICBP. They compared survival rates of four different cancers (breast, ovarian, colorectal and lung) in 12 jurisdictions in six countries: Australia, Canada, Denmark, Norway, Sweden and the UK (England, Wales and Northern Ireland, but not Scotland). The data covered 2.4 million adults diagnosed with the target cancers between 1995 and 2007, with follow-up to the end of December 2007.

The data covered 2.4 million adults diagnosed with primary colorectal, lung, breast (women), for ovarian cancer between 1995 and 2007, with follow-up to the end of December 2007.

The researchers prepared their estimates of 1 and 5 year relative survival rates in 252 "life tables" controlled for background mortality by age, sex and calendar year.

The study found that:

Relative survival for all four cancers improved in all countries from 1995 to 2007.

Survival rates were persistently higher in Australia, Canada and Sweden.

Survival was intermediate in Norway, and lower in Denmark and the UK (England, Northern Ireland, and Wales).

For example, in the case of bowel cancer, there was more than 12 percent difference in survival rates between the lowest performer, the UK, and the highest performer, Australia.

And in the case of lung cancer, only 8.8 percent of UK patients survived until 5 years after diagnosis compared with 18.4 percent in Canada.

Differences in survival rates were particularly noticeable for the first year after diagnosis and for patients aged 65 years and older.

For breast cancer the disparities were much narrower for all ages, but much less so or not at all for the other cancers (for breast cancer the international differences narrowed from about 9 percent to 5 percent for 1-year survival and from about 14 percent to 8 percent for 5-year).

For colorectal cancer, the disparities narrowed only for patients age 65 and over.

The researchers conclude that "Trends in cancer incidence and mortality are broadly consistent with these trends in survival." They deny that "data quality and changes in classifications are not likely explanations for these disparities in survival rates. The patterns are consistent with later diagnosis or differences in treatment, particularly in Denmark and the UK, and in patients aged 65 years and older," they add.

Researchers focused not on particular doctors or specialists, but "how people are channeled through the healthcare system to optimal treatment," they explained. They encouraged governments, when reviewing cancer strategy, to keep focusing on early diagnosis and improving equal access to treatment.

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