Press Release - Tackling cancer in England: saving more
lives
19 March 2004
Sir John Bourn, head of the National Audit Office, reported
today that cancer patients are increasingly surviving the disease
as a result of the new initiatives launched by the Department of
Health and the NHS over the last decade. But the NHS needs to
continue to do more to ensure all patients are treated swiftly and
appropriately.
The incidence of cancer has grown by 31 per cent since 1971, in
part owing to lifestyle factors such as the trend up to the late
1960s for a greater number of women to smoke and the trend for
increased exposure to sunlight. However, survival rates are up and
death rates have fallen by 12 per cent in the last 30 years.
Progress varies by type of cancer. Detection and treatment of
breast cancer have improved strongly with survival rates now
approaching 80 per cent. However, in the absence of means of
detecting lung cancer in its early stages, patients diagnosed with
lung cancer then live on average for only four months, highlighting
the importance of effective prevention measures for this
cancer.
Cancer mortality rates for men in England and Wales now compare
very favourably with other countries (for example, France, Spain
and Germany), but have further to go for women, in part a
reflection of the timing of the take up of smoking in different
countries. Comparison of survival rates is less straightforward but
indicates that England has not been doing as well as the best in
Europe, such as Sweden or the Netherlands. Improvements in survival
rates for the most deprived people are increasing more slowly than
for the most affluent.
People in England with cancer have tended to be diagnosed at a
more advanced stage than people with cancer in countries with
better survival rates. Today’s report call for more action to
tackle the delay on the part of some patients to come forward for
medical advice when they have suspicious symptoms Those most
strongly suspected by GPs of having cancer are now assessed
promptly, but a significant proportion of those with cancer have
not been referred urgently and have therefore had to wait a number
of weeks longer for assessment by a consultant. Today’s report
recommends that GPs should have better guidance on referring
patients with suspected cancer and that the Department of Health
should develop a mechanism for assessing the time taken for
patients who are referred routinely and subsequently diagnosed with
cancer to be assessed and treated.
Delays in diagnosis are a continuing problem. This is chiefly
due to shortages of endoscopists, pathologists and radiographers.
The Department is taking action to address this.
More patients are receiving appropriate treatment but there are
still inequalities in the availability of some treatments, such as
approved drugs, and timely access to other interventions, such as
radiotherapy. Survival rates for cancers consistently favour London
and the south of England, whereas the North East of England suffers
the lowest survival rates.
Today’s report highlights the fact that the most effective way
of preventing cancer is for people to stop smoking. One
contribution to this is that the NHS has encouraged hundreds of
thousands of people to stop at least for a short period. An
evaluation is underway to find out how many of those remain
non-smokers in the long term. Strategic Health Authorities vary
substantially in referral rates to stop smoking services and the
number of patients quitting for at least four weeks. The NAO
recommends that strenuous efforts be made to bring all services up
to the level of the best.
Sir John Bourn said today:
"The chances of surviving cancer are improving all the
time. Under the determined leadership of the National Cancer
Director, Professor Mike Richards, the Department and NHS have
achieved a great deal in a short time. Saving an even larger number
of lives requires more of us to know and act promptly on the
possible symptoms of cancer.
"But the Department and NHS need to act to further
reduce inequalities, geographical and between the affluent and
deprived, and go on improving cancer prevention, screening,
referral, diagnosis and treatment services. These are essential
steps in meeting the Department’s goal to make England’s cancer
services among the very best in Europe by the end of this
decade."
Notes for Editors
- More than one in three people in England will develop cancer at
some point in their life. One in four will die from it. There are
about 225,000 new cases per year in England, and some 130,000
deaths. The leading four cancers – breast, lung, bowel and prostate
- account for about half of new cases and deaths.
- There are 3 main measures of cancer outcome:
Incidence – the number of cancers which occur each year in
a population of given size
Mortality – the number of people in a population of given
size who die from cancer each year
Survival – how long patients with a given type of cancer
live on average after diagnosis (the proportion alive after five
years is a standard measure)
- The 2000 NHS Cancer Plan was a comprehensive strategy to
improve cancer outcomes:
lowering levels of incidence, lowering cancer mortality rates and
increasing survival for those with the disease. The Department of
Health recently published The NHS Cancer Plan: three year
progress report – maintaining the momentum which can be found
at
http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/fs/en.
- Press notices and reports are available from the date of
publication on the NAO website,
which is now at www.nao.org.uk. Hard copies can be obtained from
The Stationery Office
on 0845 702 3474.
- The Comptroller and Auditor General, Sir John Bourn, is the
head of the National Audit Office which employs some 800 staff. He
and the NAO are totally independent of Government. He certifies the
accounts of all Government departments and a wide range of other
public sector bodies; and he has statutory authority to report to
Parliament on the economy, efficiency and effectiveness with which
departments and other bodies have used their resources.
Press Notice 22/04
All enquiries to Barry Lester, NAO Press Office: Tel: 020 7798
7937
Mobile: 07748 181692