Good progress has been made on improving cancer care in England, the National Audit Office says.
Speedier treatment is a key target
The NAO's report was upbeat about efforts to meet targets set out in the government's 10-year cancer plan published in 2000.
It said 34 cancer networks of local NHS trusts and specialists had been set up, and achieved important improvements.
However, it warned that more work and better collaboration were needed if the targets were to be fully met by 2010.
The report said good progress had been made on most of the major targets, with many either met or on course to be met.
These included improving screening, speeding up access to diagnosis and treatment and increasing the number of specialists.
The creation of cancer networks had helped improve the introduction of new cancer drugs, and led to a more effective approach for funding specialist palliative care.
Target - Min 20% reduction (to 113.0) from baseline rate
Rates are three-year averages
But the report also found sufficient resources were not always available to enable networks to operate effectively, and some had vacancies in essential posts.
Not all networks plan effectively, with only around a third having produced workforce or education and training strategies.
A more collaborative approach was required by the constituent organisations within the networks, and by the Primary Care Trusts who commission cancer services.
The report said decisions need to be taken now on how to update and bring together all elements of the current cancer strategy in a unified way.
It recommends the Department of Health publish an annual progress report.
Sir John Bourn, NAO head, said: "Substantial progress has been made in implementing the NHS Cancer Plan, with many targets in the Plan met or on course to be met.
"This should contribute to the downward trend in cancer mortality rates and continue to bring significant benefits to patients.
"Cancer networks have achieved much but there is more to be done if they are all to become fully effective: including better planning, more co-ordinated commissioning of cancer services, proper resourcing, and effective co-operation between constituent organisations."
Health Secretary John Reid said the government had made a major investment in cancer services.
"We want to do even better.
"By the end of this year we want no patient to wait longer than 31 days from diagnosis to treatment and no longer than 62 days from being urgently referred by their GP to treatment.
"We know this will be challenging but it is achievable."
For the Tories, Edward Leigh, chairman of the Public Accounts Committee, said the government was struggling to meet targets on speedy treatment for cancer patients, and helping smokers to quit.
National Cancer Plan 2000
Cancer survival rates in the UK will be among the best in Europe within 10 years
Increase the number of cancer specialists working in the NHS by one third
All cancer patients treated within four weeks of diagnosis by 2005
Maximum two month wait from urgent GP referral to treatment for all cancers by 2005
Reduce smoking rates among manual groups from 32% in 1998 to 26% by 2010
He said there was a danger the impact of cancer networks could be diluted by changes such as the introduction of more autonomous bodies, such as foundation trusts.
"Steps must be taken to ensure that all the NHS organisations engaged in the fight against cancer work with common purpose and truly effective partnership."
Professor Karol Sikora, a leading oncologist, took issue with the upbeat nature of the report.
He said: "The report's optimistic conclusion fails to reflect the disturbing reality of the state of cancer services.
"It is based on an overall reduction of cancer mortality, something that has been going on for thirty years, mainly due to improvements in lifestyle such as a reduction in smoking.
"What really matter is what happens to cancer patients who are diagnosed as having cancer today.
"On this measure Britain still lags far behind most other countries in Europe and the US."
Professor John Toy, of Cancer Research UK, stressed that the most effective way to cut cancer deaths would be to introduce a complete ban on smoking in public places.
Anna Wood, of Breast Cancer Care, said: "There has been excellent progress in meeting the major breast cancer targets set out in the Plan.
"However, there are still key areas of concern that need to be tackled, particularly long delays for radiotherapy treatment, and delays for non-urgent cancer referrals."
Peter Cardy, of Macmillan Cancer Relief, said the cancer plan was too narrowly focused on acute care. A greater emphasis was required on palliative care, he said.