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Last Updated: Friday, 19 March, 2004, 00:21 GMT
Wide variation in cancer services
Radiation therapy
Cancer survival rates in England are increasing
England has come a long way in improving cancer survival rates in the past 30 years but still does not match up to Europe and the US, a report says.

The National Audit Office found cancer rates have risen by 31% since 1971, but death rates have fallen by 12%.

It also showed a regional difference with people more likely to die of cancer in the north than in the south.

The report called for heightened public awareness, faster referrals and diagnosis and more specialists.

As survival from cancer has improved, the gap in cancer survival between rich and poor sections of society has widened.
Dr John Toy, Medical Director, Cancer Research UK
The report, called Tackling Cancer in England: Saving More Lives looked at the four main cancers in England: breast, lung, bowel and prostate.

It found fewer men died of cancer in England compared to Germany, Spain, the Netherlands and France.

However among women England had the second highest rate and only Scotland was higher.

Figures were taken from 1998, the year for which there are the most recent statistics.

'A north-south divide'

Overall survival rates in men and women were found to be increasing in England, but were still poor compared to Sweden, Finland, the Netherlands and Denmark.

Survival rates also vary widely between types of cancers. Almost 80% of women in England survive breast cancer, but lung cancer patients only live for an average of four months after diagnosis.

Statistics showed Sweden and the US to generally have the best results.

Cancer patients across the UK need reassurance that an end to postcode prescribing is in sight.
Joanne Rule

Report author Jeremy Gostick said: "England still has some way to go before its survival rates matches those in Europe and the US."

He said it largely came down to the stage of cancer at diagnosis.

The report found people in Europe are being diagnosed with cancer earlier than they are in England.

In poor areas of England, late-stage diagnosis was particularly prominent.

"There is evidence that people in deprived areas tend to get diagnosed at a later stage," Mr Gostick told the BBC.

He said this is because "there is a low level awareness of cancer symptoms and delays in approaching GPs with them".

However he added there was no evidence to show a lack in quality of treatment in these areas.

The report also showed survival rates to be much higher in the in the south-east than in the north-east. Lung cancer survival rates in areas of the north and in Yorkshire were almost one third lower than in London.

'Not civilised'

Edward Leigh, chairman of the Public Accounts Committee, said health inequalities have "no place in a civilised society".

He added the report "depressingly confirms the existence of a cancer health-divide".

"Those on the wrong side of it are likely to live in areas of higher deprivation which have higher rates of incidence of cancer and of death from the disease," he said.

Dr John Toy, medical director at Cancer Research UK said their own figures "have shown that as survival from cancer has improved, the gap in cancer survival between rich and poor sections of society has widened."

In addition to this, the report found a 'postcode lottery' still exists in providing access to anti-cancer drugs.

Joanne Rule, CancerBACUP's chief executive said: "Cancer patients across the UK need reassurance that an end to postcode prescribing is in sight."

Delyth Morgan, of the charity Breakthrough Breast Cancer, said: "The report points out that 98% of breast cancer cases referred as urgent are seen within the government's target of two weeks and while this is to be applauded, the stark fact is that 40% of all breast cancer cases diagnosed each year are initially referred as routine by their GP.

"We estimate this to be around 10,000 women who are being asked to put their lives on hold and endure long routine waits of up to 17 weeks for their eventual breast cancer diagnosis. Clearly this is unacceptable."

Pilots

The report suggests the Department of Health run pilots with groups of people that are consistently diagnosed with cancer at a late stage, to work out why there are delays in coming forward.

It also encouraged hospitals and GPs to develop standard referral procedures.

The report showed a shortage of radiographers, pathologists and endoscopists are also causing delays in treatment.

Professor Mike Richards, the government's National Cancer Director said the Department of Health "has implemented a range of measures to improve the recruitment and retention of NHS staff".

"As a result 300 radiographers have returned to work since April 2001 and the number of training places in diagnostic radiography has more than doubled."




WATCH AND LISTEN
The BBC's Sophie Hutchinson
"There is still some way to go to catch up with standards in Europe"



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