What cancers are hardest to survive?

The cancers with the lowest five-year survival estimates are mesothelioma (7.2%), pancreatic cancer (7.3%) and brain cancer (12.8%). The highest five-year survival estimates are seen in patients with testicular cancer (97%), melanoma of skin (92.3%) and prostate cancer (88%).

nuffieldtrust.org.uk - Cancer survival rates | The Nuffield Trust

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Background

Cancer survival is one of the key measures of the effectiveness of cancer services. Survival rates capture both how good the system is at detecting the disease and whether people have rapid access to effective treatment. There is currently a huge variation in survival between cancer types, resulting from a range of patient-level, treatment and biological factors. Diagnosis at an earlier stage of a cancer’s development is associated with improved outcomes and increased survival chances. Early diagnosis can be improved through reducing cancer waiting times, such as the time people wait to see a specialist after an urgent referral from a GP, or the time people wait for diagnostic tests. It can also be improved through public health interventions, such as screening programmes and education campaigns. In this indicator we look at the proportion of cancers diagnosed at an early stage, for eight common cancers. While cancer survival rates vary between countries, there is recognition that the UK performs less well than other comparable countries. This may result from differences in access to care, and delays in diagnosis and treatment, but it may also be due to population-level factors. We have used data from the Organisation for Economic Co-operation and Development (OECD) to compare the UK's five-year survival rates for breast, cervical and colon cancer with 17 other countries. The most recent data presented here for cancer stage at diagnosis is from February 2022, but the latest data for cancer survival rates is from before the coronavirus (Covid-19) pandemic. The pandemic caused considerable disruption to cancer services, which is likely to affect cancer survival, but estimating the impact is difficult. Please see these websites for more information about cancer survival, and for support and information about prognosis.

Cancer survival rates by cancer type

Here we look at the five-year net survival estimates for adults (aged 15-99 years) in England diagnosed with one of the 27 most common cancers between 2014 and 2018 and followed up to 2019. The cancers with the lowest five-year survival estimates are mesothelioma (7.2%), pancreatic cancer (7.3%) and brain cancer (12.8%). The highest five-year survival estimates are seen in patients with testicular cancer (97%), melanoma of skin (92.3%) and prostate cancer (88%).

Early diagnosis of cancer

The stage at which a cancer is diagnosed describes the size of a tumour and how far it has spread from where it originated. The numerical staging system classifies cancers into four stages, with stage 1 as the earliest stage. At both stage 1 and 2, the cancer has not spread to anywhere else in the body, although stage 2 indicates that the cancer has grown. If cancer is diagnosed at a later stage, once it has spread, then chances of survival decrease as effective treatment becomes more difficult. This chart focuses on eight common cancers: prostate, breast, lung, colorectal, urological, gynaecological, melanoma and oesophago-gastric. In 2018 and 2019, the number of cancers diagnosed at each stage remained roughly constant, with an average of 42% of cancers diagnosed at stage 1 or 2. Between March and May 2020, following the onset of the Covid-19 pandemic, the total number of cancers diagnosed fell by 36% from 18,077 to 11,566. Over the same period, the proportion diagnosed at stage 1 or 2 decreased from 44% to 36% and the proportion diagnosed at stage 4 increased from 15% to 21%. Since then, the number of cancers diagnosed has increased to similar levels seen before the pandemic. In December 2021, 18,400 cancers were diagnosed and 40% of cancers were recorded as being diagnosed at stage 1 or 2. Caution should be taken when interpreting data for January and February 2022 as it is less complete than previous months. The portion of cancers diagnosed where the stage is unknown has been increasing over time; in December 2021. 38% of diagnosed cancers did not have a stage recorded, (see ‘About this data’ for more information).

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The NHS Long Term Plan set a target to increase the percentage of cancers diagnosed at stage 1 or 2 to 75% by 2028. To meet this goal, early diagnosis will have to increase considerably. In April 2020, a new faster diagnosis standard was introduced, and in March 2021 the target was set which states that 75% of patients should be told whether or not they have cancer within 28 days of an urgent referral from their GP or a cancer screening programme.

Early cancer diagnosis rates by deprivation

Early-stage diagnosis comprises cancers diagnosed at stage 1 or stage 2 of the disease progression. Individuals living in the least deprived areas have had a consistently higher rate of early cancer diagnosis than those living in the most deprived areas. In 2018 and 2019, the number of cancers diagnosed at an early stage for both groups remained roughly constant, with slightly more variation occurring for individuals living in the most deprived areas than for those living in the least deprived areas. Between March and May 2020, following the onset of the Covid-19 pandemic, the percentage of cancers diagnosed early fell from 58% to 52% for individuals from the least deprived areas. The decline for the same time period was sharper for individuals from the most deprived areas as early diagnoses fell from 53% to 41%. Since then, the percentage of early cancer diagnoses has increased to levels akin to before the pandemic for both groups. In June 2022, 61% of cancers were diagnosed early for individuals in the least deprived areas and 52% were diagnosed early for individuals in the most deprived areas. Although early cancer diagnosis rates for both groups are less than the 75% target set for 2028 by the NHS Long Term Plan, it should be noted that individuals living in the least deprived areas are substantially closer to the target than individuals living in the most deprived areas.

Breast cancer survival rates by country

Breast cancer is the most prevalent cancer in women worldwide. Survival is related to advances in treatment, detection through screening programmes and a greater awareness of the disease. Five-year survival for breast cancer has been improving in the UK over time, reaching 85.6% in 2010-2014. However, despite the relatively high breast cancer screening coverage when compared with several other OECD countries, the UK continues to lag behind in terms of survival. The United States reached the highest five-year breast cancer survival rate of 90.2% in 2010-2014, followed closely by Australia at 89.5% and Japan at 89.4%.

Cervical cancer survival rates by country

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Cervical cancer is highly preventable if detected and treated before progression occurs. The main cause of cervical cancer is sexual exposure to human papilloma virus (HPV). About half of OECD countries have cervical screening programmes and around half have implemented HPV vaccination programmes. In England, all girls aged 12 to 13 are offered the HPV vaccination, and from the 2019-20 school year the programme has been extended to all boys aged 12 to 13 years old. In recent years, uptake of the first dose of the vaccine has fluctuated around 89% and uptake of the second dose is slightly lower at around 84%. International trends in five-year cervical cancer survival show more variation between countries over time than for five-year breast cancer survival. While survival has been improving in the UK, the country is still one of the worst performers compared with other OECD countries, with a five-year survival of only 63.8% in 2010-2014. This is despite relatively high cervical cancer screening coverage. In comparison, survival in Denmark in the same time period was 69.5% while survival in Japan reached 71.4%.

Colon cancer survical rates by country

Bowel cancer is the third most commonly diagnosed cancer worldwide. The disease has a higher prevalence in America and Europe than Asia, however in countries where people are adopting Western diets, such as Japan, the incidence of colon cancer is increasing. There are multiple screening methods available including the faecal occult blood test, colonoscopy and flexible sigmoidoscopy. Advances in diagnosis and treatment of colon cancer have led to increased survival over the last decade. While the five-year colon cancer survival rate in the UK has been increasing over time, in 2010-2014 survival reached only 60%. This is the lowest five-year survival rate out of the 18 OECD countries that we have included. Over the same time period in Australia it was as high as 70.6%, and Belgium reached a five-year colon cancer survival rate of 67.9%.

nuffieldtrust.org.uk - Cancer survival rates | The Nuffield Trust

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