Data shows that mortality can be reduced without matching international spending on cancer
The NHS is achieving impressive reductions in deaths from cancer when compared to other countries, despite having a smaller budget, according to a new study.
Writing in the British Journal of Cancer, study authors Professor Colin Pritchard and Dr Tamas Hickish use data from the World Health Organisation to show that the cancer mortality rate for men (aged 15-74) in England and Wales fell by 31% between 1979-1981 and 2004-2006, a fall "significantly greater" than that achieved by seven of the ten countries included in the study (Australia, Canada, England and Wales, France, Germany, Italy, Japan, Netherlands, Spain and the United States). This means that England and Wales has the sixth highest cancer mortality rate in the group, behind both France and Spain but above Australia and Japan. In 1979-1981 it had the third highest rate.
Previously, England and Wales had the highest cancer mortality rate for women; it now has the second highest rate, below the Netherlands, following a 19% reduction. The rate among women aged 55-64 has fallen by a greater amount than in seven other countries and in women aged 65-74 by a greater amount than in four other countries.
Challenging the 'sick man' story
For several years, England has been presented as "the sick man of Europe" when it comes to cancer survival and the current government has consistently cited the UK’s poorer record on cancer survival as justification for reforming the NHS. Findings from one study (Abdel-Rahman MA, Stockton DL, Rachet B, et al. in the British Journal of Cancer) suggest that for patients diagnosed up to 1999, about 11,400 more cancer patients died every year within five years of diagnosis in England, Scotland, and Wales than if five-year survival rates had been as high as the highest levels achieved in 13 other countries in Europe. The current national cancer strategy states that, if England was to achieve cancer survival rates at the European best, then 10,000 lives would be saved every year.
However, the Government has previously been criticised for its use of statistics to support its reforms. King’s Fund economist John Appleby pointed out in the British Medical Journal earlier this year that comparisons with other countries on cancer deaths "are not straightforward and depend where you look". For example, death rates for breast cancer have fallen by 40% since 1989, virtually closing the gap with France where they have fallen by just 10%.
Now Professor Pritchard is arguing that the data in his study supports the current approach to improving cancer outcomes adopted by the NHS and that the Government's proposed reforms - opposed by many - need to be reconsidered in the light of his findings.
Value for money
Importantly, the study looked at the "effectiveness and efficiency" of the strategies for improving cancer outcomes adopted in the ten countries to - how much reduction in cancer deaths do you get for your money?