The Department of Health, its arms length bodies and the NHS have made progress in improving cancer services since 2010, according to the National Audit Office. However, significant variations in outcomes and access to services persist across England, indicating that there is considerable scope for further improvement.
Since the NAO last reported on cancer services, in 2010, overall outcomes for cancer patients have continued to improve. For example, the proportion of people surviving for one year and five years after diagnosis has increased to 69% (for those diagnosed in 2012) and 49% (for those diagnosed in 2008) respectively. However, data on 5-year survival rates published in 2013 (for those diagnosed between 2000 and 2007) showed that survival rates remained about 10% lower than the European average.
Good progress has been made in implementing the recommendations made by the Public Accounts Committee in 2011. As a result, although some data gaps remain, better information is becoming available to support improvements in cancer care. For example, the proportion of newly diagnosed cancers with ‘staging data’ (a record of how advanced a person’s cancer is at diagnosis) increased from 33% of cases in 2007 to 62% in 2012.
However, outcomes for cancer patients and access to services vary significantly across the country. They are generally poorer for older patients in particular. Cancer patients aged 55-64, for example, are 20% more likely to survive for at least one year after diagnosis than those aged 75-99. While survival rates for people in the latter age group are expected to be lower because, for example, they are frailer and less likely to cope with treatment, this is unlikely to explain fully this significant variation between age groups.
Those from more deprived socio-economic groups are also more likely to experience worse outcomes than those from less deprived groups. There would be nearly 20,000 fewer deaths from cancer each year if mortality rates for all socio-economic groups were the same as for the least deprived.
In addition, while cancer awareness campaigns have increased awareness of cancer signs and symptoms, one in five people are still diagnosed via an emergency presentation. Those diagnosed in this way are, on average, twice as likely to die within a year as those diagnosed through an urgent GP referral because their cancers are generally more advanced.