Page last updated at 11:14 GMT, Friday, 20 March 2009

Row over impact of cancer policy

Cancer diagnosis
The NHS cancer plan was launched in England in 2000

The NHS cancer plan may have helped boost survival rates in England, a study suggests - but experts are split over its real impact.

A comparison with Welsh data suggests "some beneficial effect" of the England cancer strategy launched in 2000.

But a leading cancer expert said the Lancet Oncology paper showed no "striking" improvement despite a huge amount of cash pumped in.

Cancer tsar Professor Mike Richards said both countries had seen benefits.

The study comes as the Office for National Statistics publishes the latest figures on cancer survival up to 2007.

Data was analysed on survival rates for 21 common cancers from more than two million patients between 1996 and 2007.

Alarmingly, there is still wide regional variation in survival, with deprivation still being linked to poor outcome - a factor the plan was meant to address
Professor Karol Sikora

Figures were broken down into before the NHS cancer plan in England (1996 to 2000), the initial set up of the 10-year strategy (2001 to 2003) and its implementation (2004 to 2006).

Survival rates were then compared with Wales where a major cancer plan was not adopted until 2006.

Overall there was slightly faster improvement in one-year survival in England than in Wales between 2004 and 2006.

But in the three years prior to that the reverse was true.

Cancer tsar Professor Mike Richards talks about the plan

Although the pattern was less clear for three-year survival, it does suggest some survival benefit in England from the cancer plan, the researchers said.

Variation

However, they also found that there are still wide regional variations.

For cancers of the stomach, colon, rectum, uterus, ovary and kidney, survival trends in England improved after 2001, even without screening or the widespread use of effective new treatments.

But bladder cancer, Hodgkin's lymphoma and leukaemia all showed a fall in survival, the figures showed.

The team, led by Professor Michel Coleman from the Cancer Research UK Cancer Survival Group at the London School of Hygiene and Tropical Medicine in London, said the findings did not produce a "definitive verdict" and called for more detailed analysis on specific parts of the cancer plan, such as shorter waiting times and the creation of multidisciplinary teams.

GOALS OF THE CANCER PLAN
Reduce smoking in adults from 28% to 24% by 2010
Maximum two-month wait from urgent GP referral to treatment by December 2005
Maximum one-month wait from diagnosis to treatment by December 2005
An extra £50m NHS investment a year by 2004 in hospices and specialist palliative care
1,000 extra cancer specialists by 2006

In an accompanying editorial, Professor Richards, the National Cancer Director for England, said the findings were robust but open to interpretation.

"Ideally, incidence, survival, mortality, experience of care and health-related quality of life should all be assessed."

He added that there had been many similarities between cancer plans in England and Wales but that Wales had moved forward faster in the early years after a major report spurred on changes in cancer care.

England had then caught up and overtaken as a result of its own cancer plan.

"This interpretation would suggest that cancer strategies backed by effective implementation plans have worked in both countries, but at different times," he said.

But also writing in the journal, Professor Karol Sikora, medical director of CancerPartnersUK, an independent sector cancer provider and a former senior figure at the World Health Organization, said huge amounts of money had been thrown at the cancer plan yet the bottom line is there is "no striking improvement."

"Alarmingly, there is still wide regional variation in survival, with deprivation still being linked to poor outcome - a factor the plan was meant to address."

He questioned the validity of bureaucratic targets and said administration and poor performance of IT in hospitals had both added substantially to the costs of cancer care.

"We need to derive value from cancer services by increasing access and quality but not cost."

Scotland implemented a cancer plan in 2001 and Northern Ireland has yet to do so.

Graph of cancer survival



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SEE ALSO
Cancer plan aims to reduce deaths
27 Oct 08 |  Scotland
Cancer plan 'needs more funding'
25 Feb 08 |  Health
Cancer care plan to be outlined
03 Dec 07 |  Health
NHS cancer plan is 'ineffective'
01 Nov 07 |  Health
NHS 'to get updated cancer plan'
30 Nov 06 |  Health
UK 'lagging' on cancer survival
21 Aug 07 |  Health

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