Lung Cancer Survival Rates

A late-December report in a UK electronic newspaper, the Daily Telegraph, suggests that cancer survival rates in that country still trail those obtained in other, equally developed Western nations like Australia, Canada, Denmark, Norway and Sweden.

Based on a study of 2.4 million adults, and comparing rates in the countries named above, the UK’s survival rate was found to be “persistently lower” when targeting cancers of the bowel, breast, ovary and lung in individuals treated for same between 1995 and 2007. A subset of data, for England, Northern Ireland and Wales, was also maintained.

And, even though survival rates improved across the board in all six countries (the UK included), the long-term survival rate of patients in England, Northern Ireland and Wales (and Denmark) was found to be disappointingly behind the average, particularly in instances where cancers were in their first year after diagnosis, and for those 65 and over.

Before taking on the bad news, the report first presented the good news; survival in the UK, from breast cancer, at five years, improved (on an internal averaging ratio) from 74.8 percent in 1995-99 to 81.6 percent between 2005 and 2007 – a span half as long but more than 6 percent improved.

This ratio beat out the five other countries included in the survey, yet the increase itself masks an underlying problem; that Britain still has the lowest breast cancer survival rate of the six after at the five-year mark. And, as researchers are quick to note, survival rates are the crucial measurement whereby the effectiveness of regional and national healthcare systems can be evaluated against a benchmark.

This study, the first in a new program designed to investigate and identify differences in cancer survival rates with an eye to improving treatment and better informing national health policies, was conducted via a cohort of 12 jurisdictions in six countries, using anonymous, individual cancer registration records for those over 15 and over, but under 100 years of age.

A second selection criteria, that individuals had been diagnosed with primary, invasive tumors during a period of 13 years (1995 to 2007), framed a theoretical query in which respondents revealed, again anonymously, their date of diagnosis, the anatomical location of the tumor and its behavior, as well as dates of birth, sex and last known status of the patient, as well as the stage the cancer had reached and what kind of treatment had been, or was being, offered.

Average survival rates were approximated based on the incidence of certain types of cancers (breast, bowel, lung) using national statistics on incidence and mortality from 1998 through 2002, and calibrating the findings based on “relative” survival rates – which takes into account both those with cancers and those without, to determine how much a given disease shortens life.

Analyzing survival rates via age-specific and age-standardized measurements, the researchers also skewed the equation by examining five-year survival in individuals who had been tracked (for their survival) during year one of the disease – a factor which allowed them to compare across countries while simultaneously mitigating the effects of very late diagnoses, which affect the overall picture.

Breast cancer survival figures narrowed the most over time, from 14 percent to 8 percent, still leaving the UK behind, however. For lung and ovarian tumors, survival rates did not decrease with any statistical significance. Colorectal (intestinal) cancer survival rates improved considerably, most notably for those 65 and over, though in the UK the improvement was again less than in the five other nations surveyed.

According to the researchers who conducted the study and generated the numbers, the variances are most likely due to treatment delays and later diagnoses, especially among older patients at lower income scales. Considerable discrepancies in diagnostic and surgical protocols might also account for some of the variance, especially in the case of breast cancers among women 65 and older.

Researchers did not evaluate the effects of obesity, physical activity, smoking, and other lifestyle risks, and some health officials believe including those in the analysis would have provided more meaningful results.

Still, the study is notable in that it may suggest (or even institute) some changes in diagnostic procedures and treatment options. As Professor Sir Mike Richards, the UK’s National Clinical Director for Cancer noted, an English campaign to deliver earlier diagnoses via public information on the signs and symptoms of bowel, lung and breast cancer may help GPs deliver more timely analyses of a specific cancerous disease process, including staging – which is so effective in choosing appropriate cancer therapies.

The study was funded by the government, and is also likely to give local doctors more timely and improved access to test results, which can be used to evaluate and record cancer statistics for future analyses. The study was published in The Lancet, a peer-reviewed medical journal.

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