Early results from NHS cancer plan show beneficial effect on cancer survival

Preliminary data from the first study assessing the National Health Service cancer plan in England and Wales indicate improvements in cancer survival from 1996 to 2007. However, the data do not yet include a definitive assessment of the plan’s effectiveness.

Researchers from the United Kingdom examined population-based survival in 2.2 million adults diagnosed with one of 21 common cancers in England and Wales between 1996 and 2006. Participants were followed through Dec. 31, 2007.

Data were extrapolated from the National Cancer Registry at the Office for National Statistics following the linkage of cancer records with data on each patient’s vital status at the National Health Service Central Register.

The researchers examined survival trends for two three-year time periods after the introduction of the plan — between 2001 and 2003 and between 2004 and 2006.

One-year survival rates improved in England and Wales for most cancers diagnosed between 1996 and 2006. For 25 out of the 35 cancer-sex combinations diagnosed in 2006, the rate for one-year survival was 60%. However, the rate for one-year survival was poor for cancers of the esophagus (15%-20%) and was rarely more than 40% for cancers of the stomach, pancreas, lung and brain.

Results further indicated that survival from cancers of the pancreas and lung hardly improved between 1996 and 2007; the rate for one-year survival from pancreatic cancer remains below 20%.

Although differences in survival trends for the four most common cancers were not striking between the Northern and Southern areas of England, the smallest improvements were seen in the Northwest region and in Wales from 2001 to 2003 as well as during 2004 to 2006.

In an accompanying editorial, Karol Sikora, PhD, medical director of CancerPartnersUK, wrote, “The National Health Service cancer plan for England was set up at least in part in reaction to data from the EUROCARE project, which showed that U.K. cancer survival was lagging behind the rest of Europe. The stated aim of the plan was: ‘By 2010, our five-year survival rates for cancer will compare with the best in Europe.’ Despite all the caveats that must be kept in mind when extrapolating from available data and when comparing across countries, the evidence presented here suggests that England is at best keeping track with improvements elsewhere, rather than closing the gap and that the 2010 target looks optimistic.”

Rachet B. Lancet Oncol. 2009;doi:10.1016/S1470-2045(09)70028-2.