There are also more than seven times as many cancer specialists per patient in Finland than in the UK, and UK spending on anti-cancer drugs is half of that in Germany and just over a third of that in France.

And while in the US there are 12 radiation therapy machines per million patients, there are only 3.2 per million in the UK.

These findings, presented at the Ninth International Congress on Anti-cancer Treatment (ICAT) in Paris last February, suggest that the UK lags behind the rest of Europe and the US on all fronts in providing the best possible cancer care.

Moreover, the findings suggest that the differences cost lives.

Health spending and cancer survival rates

Country	Health spending as % of GDP	Age-standardised cancer deaths per 100,000 people	Five-year survival rates
			Colon cancer	Breast cancer
USA	12.7%	N/A	60%	82%
Germany	10.5%	196.7	48%	68%
Switzerland	9.8%	182.1	51%	76%
France	9.6%	194.3	45%	72%
Netherlands	8.6%	206.8	50%	72%
Italy	7.6%	199.9	42%	72%
Spain	7.6%	179.8	46%	64%
Finland	7.5%	163.0	49%	75%
Sweden	7.2%	161.3	N/A	N/A
UK	6.9%	206.5	36%	63%
Denmark	6.4%	226.5	38%	69%
Source: World Health Organisation, 1998; Berrino et al, 1995; Murray 1998; World Bank,1993

Dr David Khayat, a cancer specialist in Paris, chaired the congress.

He said: "Cancer survival outcomes vary widely throughout Europe. There is an increasingly clear link between health care expenditure and cancer survival."

Professor Herbert Pinedo, a cancer specialist at Vrije University in Amsterdam, presented the research making the link.

He said about a million people in the European Union are diagnosed with cancer each year, while more than 750,000 die of the disease annually.

Cancer is responsible for one in four deaths in the EU and is the second biggest killer after diseases of the heart and blood circulation system.

He said: "We recognise that funding is one of many factors influencing cancer outcomes. However, we believe the data suggest that current levels of funding across Europe are inadequate.

"With increased investment, mortality from cancer in the EU could be reduced using currently available interventions, techniques and knowledge."

'Drugs are underfunded'

The Campaign for Effective and Rational Treatment, a group of doctors and other health professionals, says that for it, the key area is the underfunding of anti-cancer drugs.

It is calling on the government to spend an additional £170m a year on them.

This might help bring the level of cancer care in the UK closer to that found elsewhere in Europe, it claims.

Margaret Willson, a spokeswoman for the group, "This would take spending up by an extra £2.92 per head to just under £4.00 - much better than France or Germany."

At the moment the UK spends £58m - or £1.00 per person - each year on cancer drugs.

This compares with £41m on acne treatment, £78m on laxatives, £87m on Aids-HIV therapy, £420m on antibiotics, £660m on ulcer therapy and £774m on drugs to lower blood pressure.

Staffing problems

The Cancer Research Campaign places an emphasis on the shortage of specialists.

Professor Gordon McVie, director of the campaign, said: "We just have too few ground troops.

"In this country a cancer specialist will see 700 new patients each year compared to a specialist in the Netherlands who sees just 300 new patients.

"What this means is that they don't really have enough time to talk about the diagnosis or give proper treatment to the cancer."

Dr Mike Cullen, chairman of the Joint Council for Clinical Oncology which represents radiologists, surgeons and physicians, agreed.

"The figures speak for themselves. They mean consultants in other countries can devote more time per patient and, importantly, they can become more specialised in one or two types of cancer.